NWSRA Programming Space Survey Question Title * 1. Name: Question Title * 2. E-mail: Question Title * 3. Phone Number: Question Title * 4. Ethnicity: White or Caucasian Black or African American Hispanic or Latino Asian or Asian American American Indian or Alaska Native Native Hawaiian or other Pacific Islander Another race Question Title * 5. Sex: Male Female Nonbinary Other Question Title * 6. Age of Participant: 3-6 7-12 13-18 19-25 26-35 36-47 48 and Over Question Title * 7. Community in which participant lives: Arlington Heights Bartlett Buffalo Grove Elk Grove Hanover Park Hoffman Estates Inverness Mt. Prospect Palatine Prospect Heights Rolling Meadows Salt Creek Schaumburg South Barrington Streamwood Wheeling River Trails Other (please specify) Question Title * 8. Please select the NWSRA programming space for which you would like to provide feedback: Buffalo Grove Hanover Park Mt. Prospect Rolling Meadows Wheeling Hoffman Estates Admin Offices at Rolling Meadows Park Central Next