2015-15 UUCW Circle Dinner Program Survey
The Circle Dinner program is designed to offer participants an opportunity to gather for a meal either in homes, at the church or out on the town for a time of fun, conversation and an opportunity to get to know other members and friends of UUCW.  Dinners usually take place on once a month basis depending on participants schedules.  If you are interested in participating in this year's Circle Dinner program, please answer the questions below and you will be notified about the scheduling the first dinner in the coming weeks!  If you have questions about this program, please contact Aaron Payson (arpayson@charter.net).
 
1.
Please enter the information indicated below.

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:
Food Allergies:
Mobile Phone:

2.

Your Group Preferences (please mark all that apply to  you)

Child-friendly Group (group meeting with children present)
Adult-only Group (21+)
Single-only Group
Young Adult Group (18-21)
Medians-only Group (21-35)
Empty-nesters Group (Post children at home)
Seasoned-only Group (65+)
LGBTQI-only Group
Women-only Group
Men-only Group
Vegetarian/Vegan-only Group
Other  
3.

Meeting Preference  (please check all that apply)

Meet in group participant homes
Meet at the church
Meet at a local restaurant
Other  
4.

Group Organizing:  Each group will have a group organizer (or co-organizers) who will help facilitate communication with participants about meeting dates/times/location, etc. Please indicate if you are interested in organizing (check all that apply).

I am willing to be a Group Organizer
I am willing to be a Group Co-Organizer
I am willing to organize the first group gathering