Piedmont CONNECT Interest Survey

Thanks for filling out the CONNECT interest survey. All information will be kept confidential and will not be shared outside the group. Don't feel you have to answer every question, just indicate your areas of interest.

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* 1. Please enter information so we know who you are:

Name: *

Email Address: *

Phone Number:

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* 2. Best way(s) to stay in touch with you:

website

phone

Facebook - join our group: CONNECT Piedmont

Twitter

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* 3. Types of events/activities you'd like to see CONNECT sponsor/support - check all that apply:

Speakers

Films

Discussion groups

Tours of homes or gardens

Community projects or work days

Family events

Action alerts

Other (please specify)

The discussion groups at the 4/24 meeting came up with ideas for areas of action. We'd like to know where your interests lie in order to set priorities. Please indicate your level of interest and involvement in each category below, and if you have other suggestions please include them in the 'Other' categories.

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* 4. Transportation

	Information Only	Participate in events	Help in planning	Help coordinate
Bike routes	Bike routes Information Only	Bike routes Participate in events	Bike routes Help in planning	Bike routes Help coordinate
Safe Routes to School	Safe Routes to School Information Only	Safe Routes to School Participate in events	Safe Routes to School Help in planning	Safe Routes to School Help coordinate
Walk to School Days	Walk to School Days Information Only	Walk to School Days Participate in events	Walk to School Days Help in planning	Walk to School Days Help coordinate
Carpooling	Carpooling Information Only	Carpooling Participate in events	Carpooling Help in planning	Carpooling Help coordinate
Public Transit	Public Transit Information Only	Public Transit Participate in events	Public Transit Help in planning	Public Transit Help coordinate
A community bus	A community bus Information Only	A community bus Participate in events	A community bus Help in planning	A community bus Help coordinate
Sunday closed street events	Sunday closed street events Information Only	Sunday closed street events Participate in events	Sunday closed street events Help in planning	Sunday closed street events Help coordinate
Reducing car use	Reducing car use Information Only	Reducing car use Participate in events	Reducing car use Help in planning	Reducing car use Help coordinate

Other (please specify)

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* 5. Gardening and Landscaping

	Information Only	Participate in events	Help in Planning	Help coordinate
No Judgement Garden Tours	No Judgement Garden Tours Information Only	No Judgement Garden Tours Participate in events	No Judgement Garden Tours Help in Planning	No Judgement Garden Tours Help coordinate
Excess Harvest Exchange	Excess Harvest Exchange Information Only	Excess Harvest Exchange Participate in events	Excess Harvest Exchange Help in Planning	Excess Harvest Exchange Help coordinate
School Garden Support	School Garden Support Information Only	School Garden Support Participate in events	School Garden Support Help in Planning	School Garden Support Help coordinate
Gardening Classes/Workshops	Gardening Classes/Workshops Information Only	Gardening Classes/Workshops Participate in events	Gardening Classes/Workshops Help in Planning	Gardening Classes/Workshops Help coordinate
Native Plant propagation & Planting	Native Plant propagation & Planting Information Only	Native Plant propagation & Planting Participate in events	Native Plant propagation & Planting Help in Planning	Native Plant propagation & Planting Help coordinate
Habitat Restoration	Habitat Restoration Information Only	Habitat Restoration Participate in events	Habitat Restoration Help in Planning	Habitat Restoration Help coordinate

Other (please specify)

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* 6. Waste Reduction & Water Conservation

	Information only	participate in events	Help in planning	Help Coordinate
Greywater systems	Greywater systems Information only	Greywater systems participate in events	Greywater systems Help in planning	Greywater systems Help Coordinate
rainwater catchment	rainwater catchment Information only	rainwater catchment participate in events	rainwater catchment Help in planning	rainwater catchment Help Coordinate
improve recycling through education	improve recycling through education Information only	improve recycling through education participate in events	improve recycling through education Help in planning	improve recycling through education Help Coordinate
Reduce use and waste	Reduce use and waste Information only	Reduce use and waste participate in events	Reduce use and waste Help in planning	Reduce use and waste Help Coordinate
plastic use reduction	plastic use reduction Information only	plastic use reduction participate in events	plastic use reduction Help in planning	plastic use reduction Help Coordinate
zero waste events	zero waste events Information only	zero waste events participate in events	zero waste events Help in planning	zero waste events Help Coordinate
less landfill packaging	less landfill packaging Information only	less landfill packaging participate in events	less landfill packaging Help in planning	less landfill packaging Help Coordinate
best products for least impact	best products for least impact Information only	best products for least impact participate in events	best products for least impact Help in planning	best products for least impact Help Coordinate
composting and worm bins	composting and worm bins Information only	composting and worm bins participate in events	composting and worm bins Help in planning	composting and worm bins Help Coordinate
local freecycle &/or sharing systems	local freecycle &/or sharing systems Information only	local freecycle &/or sharing systems participate in events	local freecycle &/or sharing systems Help in planning	local freecycle &/or sharing systems Help Coordinate

Other (please specify)

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* 7. Food and Health

	Information only	participate in events	Help in Planning	Help Coordinate
Schools and nutrition	Schools and nutrition Information only	Schools and nutrition participate in events	Schools and nutrition Help in Planning	Schools and nutrition Help Coordinate
education on toxins	education on toxins Information only	education on toxins participate in events	education on toxins Help in Planning	education on toxins Help Coordinate
green cleaning products	green cleaning products Information only	green cleaning products participate in events	green cleaning products Help in Planning	green cleaning products Help Coordinate
CSA - Community Supported Agriculture	CSA - Community Supported Agriculture Information only	CSA - Community Supported Agriculture participate in events	CSA - Community Supported Agriculture Help in Planning	CSA - Community Supported Agriculture Help Coordinate
Community Gleaning group	Community Gleaning group Information only	Community Gleaning group participate in events	Community Gleaning group Help in Planning	Community Gleaning group Help Coordinate
Cooking Classes	Cooking Classes Information only	Cooking Classes participate in events	Cooking Classes Help in Planning	Cooking Classes Help Coordinate

Other (please specify)

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* 8. Energy Use and Conservation

	Information only	participate in events	Help in Planning	Help Coordinate
Home energy Audits	Home energy Audits Information only	Home energy Audits participate in events	Home energy Audits Help in Planning	Home energy Audits Help Coordinate
Tracking Piedmont's energy progress	Tracking Piedmont's energy progress Information only	Tracking Piedmont's energy progress participate in events	Tracking Piedmont's energy progress Help in Planning	Tracking Piedmont's energy progress Help Coordinate
Info on Energy Efficienct upgrades	Info on Energy Efficienct upgrades Information only	Info on Energy Efficienct upgrades participate in events	Info on Energy Efficienct upgrades Help in Planning	Info on Energy Efficienct upgrades Help Coordinate
Info on low cost loans to improve Energy Efficiency	Info on low cost loans to improve Energy Efficiency Information only	Info on low cost loans to improve Energy Efficiency participate in events	Info on low cost loans to improve Energy Efficiency Help in Planning	Info on low cost loans to improve Energy Efficiency Help Coordinate
Home tours - Energy Efficiency and/or renewable	Home tours - Energy Efficiency and/or renewable Information only	Home tours - Energy Efficiency and/or renewable participate in events	Home tours - Energy Efficiency and/or renewable Help in Planning	Home tours - Energy Efficiency and/or renewable Help Coordinate
Engaging community in energy issues	Engaging community in energy issues Information only	Engaging community in energy issues participate in events	Engaging community in energy issues Help in Planning	Engaging community in energy issues Help Coordinate

Other (please specify)

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* 9. Art - Sustainable or Recycled Materials

	Information only	Participate in Events	Help in Planning	Help Coordinate
Community art projects	Community art projects Information only	Community art projects Participate in Events	Community art projects Help in Planning	Community art projects Help Coordinate
Workshops in methods and sources	Workshops in methods and sources Information only	Workshops in methods and sources Participate in Events	Workshops in methods and sources Help in Planning	Workshops in methods and sources Help Coordinate
Collaboration with other artists	Collaboration with other artists Information only	Collaboration with other artists Participate in Events	Collaboration with other artists Help in Planning	Collaboration with other artists Help Coordinate
Outreach to needy communities	Outreach to needy communities Information only	Outreach to needy communities Participate in Events	Outreach to needy communities Help in Planning	Outreach to needy communities Help Coordinate

Other (please specify)

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* 10. Interest groups or affiliations: examples: City Council, School Green Committee, Harvest Festival etc. so we know what community groups are represented in our membership.

Piedmont CONNECT Interest Survey

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* 1. Please enter information so we know who you are:

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* 2. Best way(s) to stay in touch with you:

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* 3. Types of events/activities you'd like to see CONNECT sponsor/support - check all that apply:

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* 4. Transportation

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* 5. Gardening and Landscaping

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* 6. Waste Reduction & Water Conservation

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* 7. Food and Health

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* 8. Energy Use and Conservation

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* 9. Art - Sustainable or Recycled Materials

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* 10. Interest groups or affiliations: examples: City Council, School Green Committee, Harvest Festival etc. so we know what community groups are represented in our membership.

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* 11. Areas of Expertise or skills you bring to CONNECT - Work, training, hobbies or passions...

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* 12. Resources or contacts to share -- for example people, websites, or organizations

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* 13. Anything else you'd like to share or comment on?