Please fill out the following questions by SEPTEMBER 27.

Completion of this interest form does not guarantee you will be able to participate in Beloved Conversations. Your answers will be used to help us determine the composition and meeting schedule of the groups.  We hope to have three circles of about 10 participants each (plus two facilitators).  Everyone expressing interest will be contacted with decisions and meeting schedules by October 21.

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1. Name

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2. Email address

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3. Preferred Phone Number (include area code)

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4. What draws you to participate in Beloved Conversations?

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5. , Are you currently involved in any of the following leadership,  committee, or other volunteer roles at UUC?

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6. If you answered "Other" to the previous question, please tell us how you are involved at UUC.

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7. Are there aspects of your experience or identity that you believe will particularly influence your perspective in Beloved Conversations?

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8. Do you identify as a person of color? 

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9. Are you available to participate in the kick-off retreat planned for Friday evening, January 24 and most of the day on Saturday, January 25?  All Beloved Conversation participants are expected to be present on both retreat dates.

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10. Please check all days/times when you could be available to meet for 2 hours every 1-2 weeks from the retreat until mid April.  All Beloved Conversations circles will be scheduled to meet at the church.  Participants are highly encouraged to attend all meetings of their circle.

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