Survey for Potential Experience/Arts Participants
RequiredRequired Question(s)
 We are very excited to let you know that Grafton County Seniors Citizens Council and the Arts Alliance of Northern New Hampshire have received a national grant to put together a series of eight-week courses in the arts for adults 55 and older. These courses will take place in the Littleton, Lebanon, Haverhill, and Plymouth areas in 2017. They will take place at GCSCC Senior Centers and local cultural venues. They will be available to participants on a donation-only basis: no fee will be charged, although donations will be gladly accepted.
You can read more about Experience/Arts here, and about potential course offerings here.
 
Could you please help us identify YOUR top interests as we plan for a very exciting year ahead? Thanks so much!
 
Required 1.

Please tell us which area is closest for you:

Littleton (Littleton Area Senior Center or local partner sites)
Lebanon (Upper Valley Senior Center or local partner sites)
Haverhill (Horse Meadow Senior Center)
Plymouth (Plymouth Regional Senior Center or local partner sites)
  • Comment:

  • 500 characters left.
Required 2.
Will you need bus transportation to attend an eight-week course at one of the locations above? 
Yes
No
Required 3.
Please indicate your interest in these course options by ranking them from 1 - 10, with #1 being your top choice, #2 your second choice, #3 your third choice, etc. 

(1 = Most interested)
 
Creative writing (poetry, memoir writing, journaling)
Gift of story (story telling, story writing, listening skills, reader's theater)
Movement/dance
Singing Strong (vocal & breathing exercises, singing, reading music)
Ceramics (pinch, coil and slab hand-building)
Painting (indoors & out), color exploration
Photographing Nature (photography, photo journals)
Creating Comics (visual storytelling, comics creation)
Woodworking, sculpture
Quilting
  • Comment:

  • 500 characters left.
4.

Do you have ideas for one or more other courses you'd like to take? Please list them here. All suggestions welcome!  

 

350 characters left.
5.

Might you be interested in volunteering to help with the program? Any particular volunteer jobs you'd be interested in (e.g., helping with promotion, assisting the course instructor, helping with set-up and logistics)? 

Yes
Mabye
  • Comment:

  • 500 characters left.
6.
Please enter the information indicated below -- this question is optional!

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Work Phone:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

We appreciate your input and look forward to your participation in Experience/Arts!