________________
Last name
JAINA Senior Citizen Housing Survey Form 2006
Spouse's last name
Address
Phone (H)
E-mail (1)
Circle or write in your answer for the following questions:
1. When would you like to move in a retirement community?
Cell
2. Which state would you like to retire in select:
Mail to: Gunvant (Gary) Shah
JAIN DIGEST Spring 2005/9 Jain Education International 2010_03
First name
spouse's first name
City
(2)
Studio
No. of years: 1 2 3 4 5 6 7 8 9 10 11-15 or
AL AZ CA FL GA IL NV NJ NY NC PA SC TX VA WV Choices: 1st 2nd
3rd
3. What kind of dwelling you would prefer (Please Circle One)?
Condo
Single Family Home
Duplex
4. Number of Bedrooms you would prefer:
5. Sq. Ft. living space would you desire: 1000
1200
Cash_
Get Mortgage
6. Amount you would be willing to invest (thousands): $125 7. How would you be paying for this? 8. Would you be willing to pay Monthly Maintenance Fee of $150 $200 $250 $300 9. Community Hall: Yes No. Community Kitchen: Yes No. Health/Sport Club: Yes 10. Number of meals you would be willing to pay and receive per day to support the kitchen facilities? 1 11. Your preference from Hospital/Shopping: in miles: 5 10 15 20 25 30 35 Not important 13. Share community with Hindu/Swaminarayan to make price affordable Yes No 14. On premise: Jain temple_ Share Hindu/Jain temple Or miles from Jain temple 15. What is your level of interest? Somewhat interested None
12. Importance of having 24-Hour Nurse on premise: Very
Somewhat
Highly interested_
16. Would you be willing to pre-book unit with a deposit of 20% of the price? Yes No
17. May we share these demographics with builders, developers or potential investors? Yes No
18. Other needs
19. Comments:
Chairman, Senior Housing Committee, JAINA 12 Ascot Place, North Brunswick NJ 08902 Phone: 732-246-4030.
profgaryshah@yahoo.com
Work
IBR
St
Prefab/Modular Home
1500
$150 $175
For Private & Personal Use Only
2BR
Zip
1800
3BR
$200 $250
years
2000
No
2 3
Senior Housing Survey 2006
www.jainelibrary.org