Bowling Together Response Form
Please fill out this survey to receive a free ceramic bowl, in exchange for your amazing civic engagement participation!
Bowls will be distributed on July 15th, from 2pm - 4pm, in a celebratory event hosted at the Clay Art Center. Thank you for your patience!
Email address *
Name (First and Last) *
Your answer
Age *
Your answer
Gender *
Your answer
Contact Information (phone number or email address) *
Your answer
Definition of Civic Engagement:
"Working with members of a community for positive social outcomes."
For example: volunteering at a food bank, being an active member of a PTA or union, working with a local community action group, etc.
Please reach out to me at for any clarifying questions!
Where did you complete your civic engagement hours? *
Your answer
Briefly summarize what you did: *
Your answer
How many hours did you work? (Minimum: 4) *
Your answer
Did you enjoy it? *
Tell me about the most meaningful or memorable part of the experience: *
Your answer
Was this the first time you've done civic engagement in Port Chester? *
If yes, what made you participate in this project?
Your answer
How likely are you to continue being civically engaged in Port Chester? *
Will not continue
Will continue
Any additional comments, requests, or questions?
Your answer
Your responses to my questions may be used to generate art in relationship to this project. Please check whether I can quote your responses with your first name attached, with no name attached, or if you want your responses to be private. *
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