Session 1 Intake Survey — From Curious to Capable

Name

AI Proficiency Level

1 — I’ve heard the word "AI" but that’s about it2 — I’ve played with it a little (Siri, tried ChatGPT once or twice)3 — I use AI somewhat regularly, but want to learn more

One key goal for this class

What I want to learn (check all that apply)

About You

1. What’s the best way to describe your comfort with technology overall?

I avoid it when I canI use it, but only what I already knowI’m comfortable and like learning new toolsI’d call myself tech-savvy

2. Have you ever used an AI chatbot before (like ChatGPT, Claude, Siri, or Alexa)?

NeverTried it once or twiceUse it occasionallyUse it regularly

Tier 1 — Build Trust

4. How would you rate your understanding of what AI actually is and how it works?

I have no idea what AI isI’ve heard the term but couldn’t explain itI have a general sense of itI understand it fairly well

5. Do you believe AI can give you wrong or made-up information confidently, as if it were true?

Yes, I know thisI’m not sureNo, I assumed it’s always accurate

6. What’s your biggest fear or hesitation about trying AI?

Tier 2 — Everyday Practical Use

7. Which of these would you like AI to help you with? (check all that apply)

Writing or editing emails and lettersUnderstanding medical bills, insurance letters, or government formsMeal planning or recipesTrip planningReading documents aloud to meTalking instead of typing (voice dictation)

8. Do you currently use voice features on your phone (like asking Siri or Google Assistant a question)?

NeverRarelySometimesOften

Tier 3 — Staying Safe

9. Are you familiar with AI voice-cloning scams (where a scammer uses AI to sound like a family member)?

Never heard of thisHeard of it, don’t know detailsUnderstand it well

10. Have you or someone you know ever been targeted by a scam call, text, or email?

YesNoNot sure

11. How confident are you in knowing what information is safe vs. unsafe to share with an AI chatbot?

Not confident at allSomewhat confidentVery confident

Tier 4 — Create and See

12. Would you be interested in using AI to restore or colorize old family photos?

Very interestedSomewhat interestedNot interested

13. Would you be interested in creating a simple video or slideshow with narration (e.g., a family memory or history project)?

Very interestedSomewhat interestedNot interested

14. Do you have any old photos, letters, or family stories you’d love to turn into something shareable?

YesNoNot sure yet

Wrap-Up

15. What’s the ONE thing you most hope to walk away knowing how to do by the end of this series?

16. Is there anything (vision, hearing, mobility, or otherwise) we should know so we can make this workshop easier for you to follow? (optional)

Thank you! Your answers help us shape each week’s pace and examples around this group.