enrichment_center_fillable

The Enrichment Center of Long Island

Family Questionnaire

Where learning, creativity, and community come together.

A vibrant place to explore passions, develop talents, and connect with others. From community events and creative workshops to inspiring programs for all ages, we're here to help families be part of a thriving, supportive community. We'd love to learn how we can support your family.

Please complete this questionnaire.
Section 1 - About You and Your Family
Name*

First NameLast Name
Q2 Email Address*
example@example.com
Q3. Phone Number

Area CodePhone Number
EmailPhoneText
YesNo
2-45-78-1011-1314-17
Section 2 - Children's Program Interests
Art & Creativity - painting, drawing, crafts, creative projectsMusic & Movement - rhythm, singing, basic music conceptsSTEM & Building - woodworking, robotics, hands-on scienceAcademic enrichment - math, reading, writing supportLife Skills & Confidence - public speaking, leadership, self-esteem activitiesHealth & Cooking - healthy snack making, nutrition, cooking basicsSports & Physical Play - soccer, basketball, dance, Ninja Warrior movement, games, active funSeasonal Camps & Special Events - holiday programs, themed days, special guest activiesOther
Section 3 - General Interests
Children's events & workshopsAdult events & workshopsFamily-Friendly activitiesArt, music, or performance programsVolunteer opportunitiesSupporting the center through donations or sponsorshipOther
Section 4 – Staying Connected & Final Notes
Monthly newsletterEvent announcements only
YesNo
Anything else you would like us to know?
Should be Empty:

Section 1 - About You and Your Family

Section 2 - Children's Program Interests

Section 3 - General Interests

Section 4 – Staying Connected & Final Notes