Survey Form

LOOKING TO THE FUTURE...

To help us better serve your needs, we would appreciate you taking a moment to fill out this brief survey. The results from the survey will help us to enhance our services and provide programs that are beneficial and of interest to the residents of the Prospect Heights Park District.

Check all programs or facilities that you would like to see the Prospect Heights Park District offer.

Teen Events			Gymnastics
Senior Programs			Arts and Crafts
Performing Arts			Home Improvement
After School Program			Wellness
Other

Do you have any suggestions for improving the Park District's website?

Please enter the Prospect Heights Park District park name or location that you frequent.

Are there any current programs or facilities that you would like to see the Prospect Heights Park District further develop?

Are you aware of the Partner Resident Agreement between the Prospect Heights, Mt. Prospect and River Trails Park District?	Yes No

If yes, which program and/or facility did you use?

If the Prospect Heights Park District were to expand facilities, please check the types that you would support.

Skateboard Park			Museum
Athletic Fields			Indoor Pool
Greenhouse			In-Line Skating
Senior Center			Bike/Walking Trail
Other

Please refer to the map below, and select the number of the area in which you live.

Including yourself, how many people reside in your home?

Using the information below, please note how many individuals in your household, including yourself, fall into each of the age categories:

0-2 yrs.		7-12 yrs.		19-20 yrs.		46-64 yrs.
3-6 yrs.		13-18 yrs.		31-45 yrs.		65+ yrs.

How many years have you resided in the Prospect Heights Park District?

Any additional comments you may have:

Thank you for helping us to do a better job in serving your needs.