Member Survey

2) Which of the following best describes your age?

13 - 17 years

35 - 54 years

18 - 22 years

55 - 61 years

Don’t wish to answer

23 - 34 years

2005 Member Survey

1) How did you come to join the Lower Bucks Family YMCA?
	YMCA information mailed to my home	Referral from another member
	YMCA information from another location	Stopped by to visit the facility
	Other YMCA or health facility	Web Site
	Newspaper article or ad	Other

3) What is your gender
		Male		Female		Don’t wish to answer

4) What is your marital status?
	Single	Widowed	Other
	Married	Divorced	Don’t wish to answer

6) How many children under the age of 18 reside in your household?
	None	Three	More than five
	One	Four	Don’t wish to answer
	Two	FIve

7) What is your zip code

6a) If you answered question 6, which of the following categories best describes the ages of the children living in your household? Check all that apply.
	Under 6 years	13 - 17 years
	7 - 12 years	Don’t wish to answer

13) How often do you use the YMCA facility checked in question 7?
	One time per week	Once a month
	2-3 times per week	2-3 times per month
	4-5 times per week	When I can find the time
	6-7 times per week	Don’t wish to answer

14) What day(s) do you visit the YMCA? Check all that apply
	Monday	Friday
	Tuesday	Saturday
	Wednesday	Sunday
	Thursday	Varies week to week

14a) What time of day do you visit the YMCA? Check all that apply
	Early morning (6 am – 9 am)	After work (5 pm – 7 pm)
	Morning (9 am – 12 pm)	Evening (7 pm – 9 pm)
	Lunchtime (12 pm – 1 pm)	Don’t wish to answer
	Afternoon (1 pm – 5 pm)

17) What other YMCA activities have you participated in?
	YMCA Volunteer	Healthy Kids’ Day
	YMCA donor	Trick-or-Treat event
	Annual Golf Outing	Special event specify
	Other specify	None

18) The following questions are designed to help the YMCA staff better meet your needs for quality facilities, staff and programs at the Y. Please rate each of the following on a scale of 1 to 5, with 1 being poor and 5 being exceptional.

12) What kind of membership do you hold?
	Family (parent with children under 18)	Adult (ages 23 – 61)
	Teen (ages 13 – 18)	Senior (ages 62+)
	Young adult (ages 19 – 22)	Program membership

19) The YMCA is guided by the core values of Caring, Honesty, Respect and Responsibility. With these values in mind, please indicate if you would strongly agree, agree, disagree, or strongly disagree with the following statements.

20) On a scale of 1 to 5, with 1 being poor and 5 being exceptional, how would you rate your overall satisfaction with the Lower Bucks Family YMCA?

20a) Why did you give it that rating?

21) Based on your experience as a member of the YMCA, on a scale of 1 to 5 where 1 is not likely at all and 5 is extremely likely, how likely are you to refer someone to join the YMCA?

21a) Why did you give it that rating?

22) What additional comments do you have that would help the YMCA staff better serve you as a member of the association?

23) Are you interested in becoming a YMCA volunteer? If YES, indicate area of interest

24) Do you have access to a computer with internet capabilities?

25) Are you interested in receiving information about the YMCA via email? If yes, please provide your email address below.

Thank you for taking the time to share your thoughts with us. We look forward to evaluating and processing your feed back.

16) What program activities do you regularly engage in at the YMCA? (check all that apply)
	Lap Swim	Fitness Center
	Family Swim	Aerobics classes
	Basketball	Y-Zone
	Weight Room	Babysitting
	Other specify	Don’t wish to answer

General	1/Poor	2	3	4	5/Exceptional
Greeting upon entering the Y lobby
Hassle-free registration
Ease of check-in
Accessibility of staff
Knowledge of staff
Ability of staff to assist you

Facility
Lobby area cleanliness
Locker rooms
Security and safety
Parking
Equipment availability
Equipment maintenance

Schedules
Facility hours
Lap and family swim times
Aerobic fitness times
Gym availability
Y-Zone hours

	Strongly Agree	Agree	Disagree	Strongly Disagree
I feel welcome at the YMCA.
I believe the YMCA is a good place to bring children.
I believe the YMCA is helping to build a stronger community.
I believe the YMCA is serving people in need of financial assistance.
I feel the YMCA staff demonstrates caring behavior at all times.
I feel the YMCA staff knows me by name
I feel I am treated with respect while at the YMCA.