Listening Circle Survey
Please fill out this form and click submit.
Name
*
Email
*
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Phone
Do you need Childcare?
Please select one option.
Yes
No
Select Option
Yes
No
Please Select below, the dates that are your
1st choice
.
In-Person
Please select all that apply.
3/6, Wednesday @ 7pm
3/10, Sunday @ Noon
3/17, Sunday @ Noon
Zoom
Please select all that apply.
3/7, Thursday @ 2pm
3/7, Thursday @ 7pm
3/12, Tuesday @ 4pm
Please Select below, the dates that are your
2nd choice
.
In-Person
Please select all that apply.
3/6, Wednesday @ 7pm
3/10, Sunday @ Noon
3/17, Sunday @ Noon
Zoom
Please select all that apply.
3/7, Thursday @ 2pm
3/7, Thursday @ 7pm
3/12, Tuesday @ 4pm
Submit
Description
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