Community Roundtable

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1. Please provide contact information.

Please provide contact information.   Name:
Address:
Address 2:
City/Town:
State:	-- select state --AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming
ZIP/Postal Code:
Email Address:
Phone Number:

2. What is the name of your community?

What is the name of your community?

3. How many staff persons attended from your community?

How many staff persons attended from your community?

4. Was the topic presented relevant to your community?

Was the topic presented relevant to your community?

5. How satisfied were you with today's program?

	Very Satisfied	Satisfied	Somewhat Satisfied	Not Satisfied
Community Presentation	*How satisfied were you with today's program? Community Presentation Very Satisfied	Community Presentation Satisfied	Community Presentation Somewhat Satisfied	Community Presentation Not Satisfied

6. Are you able to travel to different meeting locations within Franklin County?

Are you able to travel to different meeting locations within Franklin County?   Yes No

Comments

7. Is there a particular topic you would like us to cover in future meetings? Some examples would be...

Is there a particular topic you would like us to cover in future meetings? Some examples would be...   Green Buildings Renewable Energy Recycling and Reuse

Other, please list.