NE Levy Center Village - Community Outreach Survey
We are conducting a survey to learn more about what types of activities and resources matter to older adults living in the northeast region of Chicago.

Your valuable input will guide planning for programs and services offered by the newly formed NE Levy Center Village. The NE Levy Center Village is a community-based organization designed to help older adults as they age in the community.

If you have any questions, want to join our email list, or wish to volunteer, please contact us at nelevycentervillage@gmail.com.
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Which ward do you live in?
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What is your age range? *
Where do you get information about activities in the community or city? (Check all that apply)
If you selected other, please elaborate:
How frequently do you attend the NE Levy Regional Senior Center? *
What programs do you currently attend at the NE Levy Regional Senior Center? (Check all that apply)
If you selected other, please elaborate:
What new programs would you like to see at the center or in the community? (Check all that apply)
If you selected other, please elaborate:
When are you able to attend programs? (Check all that apply) *
Required
What services interest you? (Check all that apply) *
Required
If you selected other, please elaborate:
Are you interested in receiving more information about the NE Levy Center Village or becoming involved with it (by joining a committee or volunteering)? *
If you answered YES (to the last question), please provide your email address and phone number.
We will not distribute your contact information to anyone outside of the Village
Your name:
Your email address:
Your phone number:
THANK YOU for your valuable input! It will help us better understand the needs and interests of our community and how the NE Levy Center Village can work to address them.
If you have any questions or comments, please contact us at nelevycentervillage@gmail.com.
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