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2. Help us develop additional programs and activities for Westfield’s seniors. Please completeyour answers for each question below. If you have any questions about the survey, please feel free to contact Brad Chananie, Co-Chair, Lifelong Westfield at 908-419-2076. 

4. What is your age?*

   1. Under 40
   2. 40-49
   3. 50-59
   4. 60-69

   1. 70-79
   2. 80-80
   3. 90 or older
6. How many years have you lived in Westfield?*
8. Do you have friends/relatives living in Westfield that you see regularly?*

   1. Yes

   1. No
10. Are you aware that Westfield offers a free curb-to-curb Senior Transportation Service to take seniors to doctor’s appointments or shopping locally? *

    1. Yes

    1. No
12. Have you ever used the Westfield Senior Transportation Service?*

    1. Yes

    1. No
14. • Are you interested in using the Westfield Senior Transportation Service?*

    1. Yes

    1. No
16. If Yes, where would you like to take it?*

    1. Doctor’s appointment
    2. Grocery shopping
    3. Other shopping

    1. Lunch downtown
    2. Visit friends nearby
    3. Attend movies at nearby theaters
18. What events, programs or activities would you be interested in attending that are sponsored by Lifelong Westfield?*

    (Please check up to five choices)

    1. Seminars/Webinars/Lectures
    2. Game Hours
    3. Breakfasts or lunches
    4. Nature walks

    1. Group chats
    2. Book clubs
    3. Movies
    4. Exercise programs

    1. Painting classes
    2. Museum trips
    3. Regional theater trips
    4. New York City Trips

20. How interested would you be if Westfield offered the following seniors’ services or facilities? Please select the a scale from the dropdown menu 1 (least interested) to 10 (most interested)

22. Free or discounted Handyman service*
    -- Select One --12345678910
23. Free or discounted yard service*
    -- Select One --12345678910
25. Free or discounted snow shoveling*
    -- Select One --12345678910
26. Free or discounted service to run errands*
    -- Select One --12345678910
28. Senior playground (with specially designed equipment for seniors): *
    -- Select One --12345678910
29. • Senior Center (a place where seniors can gather, eat, attend events):*
    -- Select One --12345678910
31. Did you know that the Fire Dep’t offers free home safety inspections for seniors?*

    1. Yes

    1. No
33. Would you like a weekly check-in phone call from Lifelong Westfield?*

    1. Yes

    1. No
35. Did you attend any Lifelong Westfield events in 2021 or 2022?*

    1. Yes

    1. No
37. What, if any, Lifelong Westfield events did you attend in 2021-2022?

    1. Health webinars
    2. Senior scam webinars
    3. Senior Services Fair

    1. Home Safety Seminar
    2. Walk with the Mayor
39. If you attended any event, what event(s) did you like the best?

    1. Health webinars
    2. Senior scam webinars
    3. Senior Services Fair

    1. Home Safety Seminar
    2. Walk with the Mayor
41. What type of home do you live in?*

    1. Single Family
    2. Multi-family
    3. Apartment/Condo

    1. Westfield Senior Housing
    2. Other
43. How many people live with you?*

    1. None
    2. 3

    1. 1
    2. 4+

    1. 2
45. Do you regularly use the internet/email?*

    1. Yes

    1. No
47. Do you have a car and drive?*

    1. Yes

    1. No
49. Are you a member of Lifelong Westfield & receive regular emails from us?*

    1. Yes

    1. No
51. If no, would you like to join Lifelong Westfield and receive regular emails about senior events and news in Westfield? *

    1. Yes

    1. No
53. If Yes, What is your name?*
55. What is the best way to reach you?

    1. Email

    1. Landline Phone

    1. Mobile Phone
57. Email Address
59. Landline Phone Number
61. Mobile Phone Number
63. Please let us know if you have any other suggestions or comments for Lifelong Westfield
Leave This Blank:


65. 1. Receive an email copy of this form.
66. Email address

    This field is not part of the form submission.

67. Submit

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