Community Ed

Community Education Interests Survey

Please complete this survey so that we may better serve you. We will be using the results of this survey to plan future Community Education courses. None of the fields in this survey are required, but including more information will help us serve you better. Click the "Submit" button at the bottom of the page when are finished.

Tell us a little about yourself.

Gender	Age	Marital Status

Do you have children? Yes No How many?

Where do you live?

City State

Would you like to be on our mailing list? If so, please enter your contact information below.

Email Address

Mailing Address

First Name	Middle	Last Name




City	State	Zip

Tell us a little about your experiences with Community Education.

Have you taken a class from Community Education recently? Yes No

If yes:

Which class or classes?
When?
Did you enjoy the experience? Yes No
Why/why not?

Preferred Phone:

Please select the subjects you are interested in taking from UVSC Community Education.

If there are any courses you'd be interested in taking that are not listed here, please indicate them in the fields below this menu.

Art & Photography Business and Professional Development Computers Crafts and Sewing Dance Finance

Debt Elimination
Retirement
Tax Preparation

Health and Wellness Hobbies and Special Interest Home and Garden Language Music Personal and Family Growth

Time Management
Organizational Skills
Parenting

Sports and Fitness Youth Categories

Additional subjects:

If you have any comments or suggestions for us or our program, please enter them here.