ACTIVITY INTEREST SURVEY - Kemerley

1 Scottish Rite Life: Appendix F ACTIVITY INTEREST SURVEY Complete the following. Your responses will be used to help develop the program of activities throughout the year, so it is very important that you provide complete responses. Name: _____ Age: _____ Best means of communicating with me is: (Please provide number or address below) Phone_____ Email_____ US Mail _____ Date: _____ 1. What specific interests do you have that you would like to see our Valley pursue during the year? _____ _____ _____ _____ 2. Do you have any ideas or suggestions for activities that would address these interests? _____ _____ _____ _____ 3. Consider for a moment these six experience areas (citizenship, service, leadership development, social, ritual, and fitness). How would your interests fit into any of these areas? _____ _____ _____ _____ Scottish Rite Life: Appendix F ACTIVITY INTEREST SURVEY Please check those activities , tours, projects, and seminars that you would like the Valley to plan as part of its program for the year.

2 __ Airport Tour __ Fishing __ Recognition Dinner __ Auto Mechanics __ Gourmet Cooking __ Shooting sports meet __ Backpacking __ Halloween party __ River rafting __ Barbecue party __ Ham radio __ Road rally __ Beach party __ Walking trail cleanup __ Rock climbing __ Bike hike __ History __ Sailing __ Family history __ Saving money __ Bowling __ Hobby smorgasbord __ Scholarships __ Buying a car __ Horseback riding __ Scuba __ Camping trip __ Hunter education __ Senior citizen education __ Canoeing __ Ice skating __ Skating __ Ski weekend __ Career clinic __ Slide show __ Cave exploring __ Job interviewing __ Snorkeling __ Child care __ Leadership Development __ Christmas party __ Lifesaving Classes __ Sports medicine __ Civil defense __ Military __ Sports safety __ College/University visit __ Sports tournaments __ Mountaineering __ State capitol __ Communications __ Movies __ Community cleanup __ Music __ Swimming __ Newsletter __ Swimming party __ Cooking __ Orientation flight __ Tennis clinic __ Cruise, sailing __ Outdoor living __ Train tripping __ Cycling __ Pancake breakfast __ United Way __ Dance __ Parents night __Watercraft __ Diet, nutrition __ Part time jobs __ Water-skiing __ Disabled citizens __ Photography __ Weather __ Drug abuse __ Physical fitness __ Easter egg hunt __ Planetarium __ Emergency preparedness __ Plants __ Winter sports __ Family picnic __ Plays __ Family sports day __ Fashion show __ Progressive dinner __ Fire safety __ First aid __ Public speaking