Copy and Paste this form then print/send or email to below addresses.
Purpose of your visit:
Purpose of your visit:
Date and Time of visit:
(Optional) If you would like us to contact you please provide :
Name:
Address:
Phone:
Email:
( ) I would like to subscribe.
1. What is your zip code? ____________
2. What is your age?
( ) 12 or under
( ) 13- 17
( ) 18- 24
( ) 25-44
( ) 45-64
( ) 65 or over
3. Which of the following libraries do you visit? (check all that apply)
( ) Atherton.
( ) Belmont
( ) Brisbane
( ) Daly City - John Daly
( ) Daly City - Serramonte
( ) Daly City - Westlake
( ) East Palo Alto
( ) Foster City
( ) Half Moon Bay
( ) Millbrea
( ) Pacifica Sanchez
( ) Pacifica Sharp Park
( ) Portola Valley
( ) San Carlos
(x ) South San Francisco - West Orange
( ) South San Francisco - Grand Avenue
( ) Woodside
( ) Bookmobile
( ) eBranch (smcl.org)
( ) Other:
4. How often do you visit our libraries?
( ) Once a week
( ) More than a week
( ) Once a month
( ) Once a year
( ) Twice a year
5. Rate the following experiences below:
1- Don't Know / Not Applicable
2- Poor
3- Fair
4- Good
5- Excellent
* Courteous Service:
* Helpful Service:
* Knowledgeable Service:
* Prompt Service:
* Library materials for children:
* Library materials for teens:
* Library materials for adults:
* Spaces for children:
* Spaces for teens:
* Spaces for adults:
* Events for children:
* Events for teens:
* Events for adults:
* Availability of computers:
* Convenient library hours:
* Helpfulness of staff:
* Your overall experience at our libraries:
6. Write other comments below.
Return to:
* Deposit in a box after the event or library front desk.
* Mail to: West Orange Library, 840 W Orange Avenue, South San Francisco, CA 94080
* Email: agwt2020@gmail.com
Your feedback is important and we'd like to hear from you so that we may provide you with better service. Thank you for your time and valuable input.
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