Retiree Service Survey

To help improve our services to you, please fill out the following form and hit the submit button at the bottom to send your responses via email to our office.

Name
Street address
City state zip
Phone optional
Faculty or Staff
Retired from dept., school or division
E-mail address
Interests, hobbies, etc
Interested in serving on retiree advisory board?		YES NO
Interested in volunteering with events such as blood drives, United Way fundraisers?		YES NO
Interested in volunteering in the office for light clerical work ?		YES NO
Interested in casual or part-time work as the need arises?		YES NO
Applicable skills?
Have you ever attended a retiree trip?		YES NO
If no, why not?		Scheduling conflict cost lack of interest in destination
Other reasons for not going
Have you attended a retiree luncheon?		YES NO
If no, why not?		Cost Not interested in speaker Schedule conflict
Other reasons for not going, suggestions for future speakers
Other comments or suggestions
Where do you get information on FSRP ?
to clear form and start over, hit		to send your form via email to FSRP