Whitney Friendship Circle
Sign Up & Pre-Survey
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Have you participated in Whitney's Senior Friendship Circle before?
Yes
No
Favorite Beverage (list two) - for ice breaker activity
Do you find it easy to make good friends?
Yes
No
Do you currently have close friends?
Yes
No
Do you feel emotionally attached with your friends?
Yes
No
N/A
If you have exciting news, who do you call first?
Do you trust your close friends?
1
2
3
4
5
skip if n/a
What do you think of "loneliness"?
Do you consider yourself lonely?
Yes
Sometimes
No
Do you feel you have no friends?
Yes
Sometimes
No
Do you feel emotionally appealing to others?
Yes
Sometimes
No
Do you feel emotionally upset (sad)?
Yes
Sometimes
No
Are you Outgoing/Friendly?
Yes
Sometimes
No
Why do you become friends with someone?
Similar/same hobbies
Same goals
Good personalities
Favorable attributes (reputation, good looking etc.)
Other
If "Other," please specify.
skip if n/a
What, if anything, makes friendships valuable to you?
Tell us about your interests! (List at least 3-5 things)
Do you share these interests with anyone you know at this time?
Yes
No
What are you looking for in our friendship circle?
Submit
Should be Empty: