Increasing the Participation of Refugee Seniors in the Civic Life of ...

Tools You Can UseSample Survey of Refugee SeniorsHow You Can Use This Tool: Your organization can use this survey to make an initialassessment of the different ways that seniors might want to get involved. You could hand it ouras a written survey or have volunteers fill it out with seniors.Instructions: Here is a list of ways that older people participate in or help their communities.Please check ways that you might be interested in helping others.This does not require you to participate. We just want to know your interest. Check all thatapply. Helping other elders Helping neighbors Helping recently arrived immigrantsor refugees Helping to organize a cultural event Helping to teach children or otheradults Participating in an ESL or citizenshipclass Helping at a community organization Helping at your church, temple ormosqueIf you are already helping yourcommunity, please describe what you do:Volunteering to serve on a committeeor a boardDonating money or items tocharity/non-profit organization Helping to improve services andbenefits for immigrants and refugees(Examples: Talking to communityorganizations, meeting with agencyofficials, etc.)Taking part in rallies or protest VotingOther (please describe):________________________________________________________________________________THANK YOU FOR YOUR HELPIncreasing the Participation of Refugee Seniors in the Civic Life of Their Communities Page 11