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Homer Township Public Library (ADULT)
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How are you communicating with family and friends? Check all that apply.
Phone calls
Text
Email
Zoom
“Snail” mail
Other:
Who do you miss the most and why?
Your answer
What have you done for fun?
Board Games
Video games
Read books
Walking
Riding bikes/skateboards
Making Tik Tok videos—upload it and send it to us!
Other:
Did you or a family/friend celebrate a birthday during quarantine?
Your answer
Did any other special occasion happen during quarantine?
Your answer
Was a special event that you were involved in get canceled (wedding, shower, etc)?
Your answer
The 2 things I look forward to doing when the Stay at Home Order is lifted are:
Your answer
What is/was your typical day like Monday thru Friday?
Your answer
What is/was your typical weekend like?
Your answer
Was your job effected by the Stay at Home Order?
Your answer
Are you working from home?
Your answer
What Zoom meeting(s) have you attended? Check all that apply.
Work
Family/friends
Program/class
Other:
What social media outlets have you used? Check all that apply
Facebook—reading / posting / both
Twitter—reading / posting / both
Instagram—reading / posting / both
Snapchat—watching / posting / both
Tik Tok—watching / posting / both
Other:
Did you do online shopping for grocery delivery or curbside pick up?
Your answer
Did you order delivery or curbside pick up from area restaurants?
Yes
No
Clear selection
What have you done to show support in your community? Check all that apply.
Chalked your driveway/sidewalk—upload a picture!
Placed hearts in your window(s)—upload a picture!
Displayed blue ribbons for healthcare workers—upload a picture!
Donated to a Meal Train
Made masks for family/friends/donations
Made signs for essential workers
Sent cards/letters to essential workers
Given an extra gratuity to deliveries/curbside pick up
Other:
How did you help a friend or neighbor?
Did shopping for an “at risk” neighbor
Helped someone who lost their job
Other:
Do you know of a local business that displayed an act of kindness?
Your answer
Did you discover a great recipe during the Stay at Home Order?
Your answer
What show(s) are you “binge watching”? What books have you been reading? What games have you been playing?
Your answer
Do you miss sports? If yes, which sport/team do you miss most?
Your answer
Have you discovered a new hobby? If yes, what is it?
Your answer
Have you been able to complete a home improvement project? If yes, what is it?
Your answer
Did you run out of any supplies?
Toilet paper
Disinfectant wipes
Other:
Did you have a special mask (special fabric, etc.)?
Your answer
Did you teach yourself a skill out of desperation (hair cut/dye, dog nail trim/groom, etc.)?
Your answer
What is your proudest accomplishment?
Your answer
What are some of the tag lines you have heard?
United Together
Stay Safe
In This Together
Wash Your Hands
Other:
Would you like to share your story if you/family member were diagnosed with Covid-19?
Your answer
Were you tested for Covid-19?
Your answer
Do you know someone who passed away due to Covid-19?
Yes
No
Would you like to leave a name for our Memoriam page?
Your answer
Name
Your answer
Address
Your answer
City
Your answer
Age
Your answer
Male/Female
Your answer
Submit
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