| What is your age group?* | 
                         | 
                    
                    |   | 
                
                        | What kind of focus or content would be most helpful or interesting to you? (check all that apply) | 
                        
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  | 
                    
                    |   | 
                
                        | Youth Interests (check all that apply) | 
                        
 
 
 
 
 
 
  | 
                    
                    |   | 
                
                        | Child Interests (check all that apply) | 
                        
 
 
 
  | 
                    
                    |   | 
                
                    |   | 
                
                        | How long of a commitment would you be willing to make (assume meeting once a week for about 1 hour)?* | 
                        
 
 
 
 
  | 
                    
                    |   | 
                
                        | What meeting format(s) would you consider attending?  Check all that apply.* | 
                        
 
 
 
 
  | 
                    
                            | . | 
                             | 
                        
                    |   | 
                
                        | Do you prefer summer, fall or both?* | 
                         | 
                    
                    |   | 
                
                        | What day(s) of the week  work best for you? (check all that apply)* | 
                        
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  | 
                    
                    |   | 
                
                            | What would increase the likelihood of your participation? | 
                             | 
                        
                    |   | 
                
                    |   | 
                
                            | If you would be willing to host/facilitate a small group, please submit your name, email and topic/area of interest. | 
                             | 
                        
                    |   | 
                
                        | Would you like to volunteer with any of our ministries? (check all that apply) | 
                        
 
 
 
 
 
 
  | 
                    
                        | Your Name | 
                         | 
                    
                        | Email Address | 
                         | 
                    
                                
                                     | 
                                
                                
                                
                                    | 
                                        
                                        
                                     |