(fill-in date?) (fill-in name of the event?) Survey...Thank You

Copy and Paste this form then print/send or email to below addresses.

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.

(   )   Already subscribed.

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. 

7.   3 Options to return this form:

Option 1.   Deposit in a box after the event or library front desk.

Option 2.   Mail to:
West Orange Library,  840 W Orange Avenue, South San Francisco, CA 94080

Option 3.   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.