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2. It is our goal to provide the community of Dubuque with the highest quality recreational programs and services possible. As the participant, the feedback that you can provide is invaluable. Thank you for taking just a few minutes of your time to help us improve upon your experiences.
4. 1) Program Title
6. 2) Program Dates
8. 3) Program Times
10. 4) Overall, how would you rate your experience?
    -- Select One --ExcellentGoodAverageBelow AveragePoor
12. 5) Please rate the following areas pertaining to your Leisure Service Experience:
14. Registration Process
    -- Select One --ExcellentGoodAverageBelow AveragePoor
16. Cost
    -- Select One --ExcellentGoodAverageBelow AveragePoor
18. Customer Service
    -- Select One --ExcellentGoodAverageBelow AveragePoor
20. Program Quality
    -- Select One --ExcellentGoodAverageBelow AveragePoor
22. Instructor
    -- Select One --ExcellentGoodAverageBelow AveragePoor
24. Facility
    -- Select One --ExcellentGoodAverageBelow AveragePoor
26. 6) If you answered Good or below in any of the above areas, please feel free to let us know how we could have improved your experience?
28. 7) How did you register for your program(s)?
    -- Select One --OnlineAdmin OfficeMail
30. 8) How did you find out about the Leisure Services Program?
    -- Select One --Leisure Services brochureCity of Dubuque websiteNewspaperWord of mouthOther (please explain below)
32. Please explain Other from above:
34. 9) Do you have suggestions for future programming?
36. 10) Would you be willing to be added to either a volunteer list or as a contact for future program instructors?

    1. Yes
    2. No
38. 11) If you answered yes, please provide your contact information:
40. Name:
42. Phone:
44. Email Address:
Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit Submit and Print

* indicates a required field