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* 1. Check the topics that are of interest to you (check all those that apply).

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* 2. Please list any other topics you would be interested in learning more about.

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* 3. What days of the week work for you? (check all those that apply)

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* 4. What time ranges work best for you? (check all those that apply)

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* 5. Do you have any barriers to attending the learning events? For example, child care, transportation, work hours, etc.

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* 6. If you would like information on becoming a member of the Task Force, please leave your information below:

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