Reporting Back

Use this survey to report back on your Neighbor2Neighbor conversations on "Are We An Us?. A reporter may call you to follow-up.

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* 1. Please give us your full name and an e-mail address or phone number for follow-up.

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* 2. Tell us the time, date and location of your event.

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* 3. How many people attended?

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* 4. Did you keep a list of attendees?

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* 5. What themes were discussed? Check all that apply.

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* 6. What key concerns were discussed?

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* 7. Did any particular facts or stories stand out as new or meaningful? If so please tell us which ones.

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* 8. Did the group agree on any proposed solutions or action steps? If so, tell us what they were.

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* 9. Share any thoughts you have about future community dialogues and Trib Talks forums.

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