Form Center

2. 
3. We appreciate your feedback as we strive to make your experience at The Centre a positive one! We will hold a drawing each quarter from survey responses for a $50 gift card valid for use on any Centre/General Recreation Program and/or activity offered through the department. Please have your receipt on hand to complete the survey and qualify for the quarterly gift card.
5. Please provide the following information in order to be contacted.
7. First Name*
8. Last Name*
10. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Phone #*
18. Email Address*
19. Receipt #*
21. Please choose the response that best describes your experience.
23. 1. Staff made me feel comfortable and were friendly, inviting, and positve.

    1. 1 - Far Below My Expectations
    2. 2 - Slightly Below My Expectations
    3. 3 - Met My Expectations
    4. 4 - Slightly Above My Expectations
    5. 5 - Far Exceeded My Expecations
25. 2. Staff was available, knowledgeable, and able to meet my needs during my visit.

    1. 1 - Far Below My Expectations
    2. 2 - Slightly Below My Expectations
    3. 3 - Met My Expectations
    4. 4 - Slightly Above My Expectations
    5. 5 - Far Exceeded My Expecations
27. 3. Please rate the ease/efficiency of your registration/check in process on the visit.

    1. 1 - Far Below My Expectations
    2. 2 - Slightly Below My Expectations
    3. 3 - Met My Expectations
    4. 4 - Slightly Above My Expectations
    5. 5 - Far Exceeded My Expecations
29. 4. On this visit, please rate your overall experience at The Centre.

    1. 1 - Far Below My Expectations
    2. 2 - Slightly Below My Expectations
    3. 3 - Met My Expectations
    4. 4 - Slightly Above My Expectations
    5. 5 - Far Exceeded My Expecations
31. 5. The facility was clean at the time of my visit.

    1. 1 - Far Below My Expectations
    2. 2 - Slightly Below My Expectations
    3. 3 - Met My Expectations
    4. 4 - Slightly Above My Expectations
    5. 5 - Far Exceeded My Expecations
33. 6. Would you recommend The Centre and our offerings to a friend?

    1. Yes
    2. No
35. Can you give a reason?
37. Please feel free to share any comments regarding the customer service that you have experienced during your visits at The Centre of Elgin.
39. If you wish to receive an email copy of this form instead of printing, please check the box below and enter your email address.
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41. 1. Receive an email copy of this form.
42. Email address

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