When did you visit the Villages of Van Buren? *

Have you previously visited the area? *
Yes
No

If yes, how many times?

What Villages did you visit? (check all that apply)
Bentonsport
Birmingham
Bonaparte
Cantril
Douds
Farmington
Keosauqua
Lebanon
Milton
Mt. Sterling
Selma
Stockport

How did you get to the Villages?
Automobile
Motorhome/Camper
Motorcycle

Where did you stay?
Hotel/Motel
Bed & Breakfast
Campground
Friends/Family
Outside of County

How many nights did you stay in the Villages?

What was your travel party size?

What was the primary purpose of your trip?

How much did you spend on Lodging:

How much did you spend on Restaurant/Bar:

How much did you spend on Gas:

How much did you spend on Grocery/Convenience Store:

How much did you spend on Other Items:

How satisfied were you with your overall trip to the Villages?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied

What was the area's main strength?

What was the area's main weakness?

What is your age?

What is your annual household income?
Less than $15,000
$15,000 - $34,999
$35,000-$54,999
$55,000- $74,999
$75,000- $99,999
$100,000 & above

Will you return to the Villages of Van Buren? *
Yes
No

How did you hear about us?

Would you like to receive updated information on occasion? *
Yes
No

If so, how?
Email (provide information below)
US Mail (provide information below)

Email Address:

Name & Mailing Address:

Additional Comments:

Security Code: *
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