Sample Survey

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Coronavirus Impact Survey – We want your feedback!

* Indicates required field

1. How worried are you about the impact of coronavirus on you personally? *

Extremely worried Very worried Somewhat worried Not so worried Not at all worried

2. What are the top three challenges you are currently facing? *

General anxiety about impact of coronavirus on my life Don’t have access to accurate information about the coronavirus Not being connected to fellow senior center members, family and/or friends Not being able to get enough food I am sick or helping others who are sick I do not have transportation to get supplies and food not to say I am not facing any challenges

What is your household income? *

Less than $10,000 $10,001 - $25,000 $25,001 - $40,000 $40,001 - $70,000 $70,001 - $100,000 Greater than $100,000 Prefer not to say

Submit

Mt. Si Senior Center is Generously Supported by the Following:

City Government
City of North Bend - City of Seattle   - City of Seattle/Aging & Disability Services -   City of Snoqualmie

County Government
King County - King County Emergency Medical Services - King County Human Services - King County Metro Transit
King County Parks and Recreation - King County Veterans, Seniors, Human Services Levy (VSHSL)

Tribal and State Government
The Snoqualmie Indian Tribe - Washington State Department of Transportation

Community Partners
Eastside Friends of Seniors -   Encompass NW -   Indian American Community Services (IACS)
I ssaquah Senior Center - Puget Sound Energy (PSE) - SAGE/POCAN   - SeaMar
Sno-Valley Senior Center - WATAP

Individual & Event-Based Giving
Individual Donations - Local Fundraisers
Membership Donations - Program Donations

© Copyright 2025 - Mt. Si Senior Center

Contact Us

Mt. Si Senior Center
411 Main Ave S | PO Box 806 | North Bend WA | 98045
www.MtSiSeniorCenter.org
425-888-3434