B''H
JASC -Jewish Active Senior Center
Questionnaire Form
1. What type of Health Fitness do you enjoy doing?
__________________________________________________________________________
2. Would you be interested in a Jewish Book Club? ____yes ____no
3. Are you interested in Adult Education? ____yes ____no
4. What topics are you interested in? ____History ____Torah Portion
_____Jewish Ethics _____Traditions _____Hebrew Language
or other _____________________________________________
5. Do you speak Yiddish? ____yes ____no
6. Do you read Hebrew? ____yes ____no
7. Do you enjoy card games? ____yes ____no / Which one?________
8. Do you know how to use the computer? ____yes ____no
9. Would you like classes to increase your computer skills? ____yes ____no
10. What kind of activities would you like to have at JASC?
________________________ _______________________ ______________________
11.Do you attend anyother Senior Centers? _____yes _____no
If yes, which one? __________________________________________________________