KPSCH Volunteers

Volunteer Survey

Kaiser Permanente Santa Clara Medical Center.
Thank you for taking this survey.
* fields are required.

I am currently a volunteer at Kaiser *

If you are NOT A VOLUNTEER, please do not submit this form. You are invited to make an application to volunteer by returning to the home page.
As a current volunteer, I have volunteered at Kaiser for: *
My age is: *

Why do you volunteer? *
	YES	SOMETIMES	NO
I volunteer to help others	1	2	3
I volunteer to develop new skills and experience	1	2	3
I volunteer to meet people and make friends	1	2	3
I volunteer to be involved in my community	1	2	3
I volunteer to use my skills in a productive way	1	2	3
I volunteer beause it is a school or community requirement	1	2	3

*

Excellent 2 3 4 About what I expected 6 7 8 9 Very disappointing

Rate your overall volunteer experience 1 2 3 4 5 6 7 8 9 10

I prefer to learn about Kaiser Santa Clara volunteer news from: *
	first choice	second choice	third choice	last choice
immediate email	1	2	3	4
daily or weekly email digest	1	2	3	4
website only	1	2	3	4
text message	1	2	3	4
RSS newsfeed to my personal webpage	1	2	3	4
telephone	1	2	3	4

additional comments?
Name (optional) First Last
Email (optional)

Evaluate the following statements.
	Strongly Disagree	Disagree	Agree	Strongly Agree
Statement One	1	2	3	4
Statement Two	1	2	3	4
Statement Three	1	2	3	4

Do Not Fill This Out

{ } Wufoo Powered