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1. Which of our Monthly Meetings are you able/more likely to attend?

* 2. Which of the following Meeting Programs are of interest to you (Please choose no more than 3 programs):

* 3. Which of the following events should the Mothers' Club run this year (Please choose no more than 3 events):

4. I would like to help run the following:

5. I would like to volunteer to help with the following:

6. If the Mothers' Club started a Scrip program (purchase of gift cards), would you participate?

* 7. Which stores would you be interested in purchasing gift cards for? (Please choose no more than 3 stores)

* 8. Which of the following trip(s) are of interest to you? (Please choose no more than 3 trips)

9. Keeping in mind the trip(s) above that you are interested in, what pricing are you willing to spend on the trip(s)?

10. Please let us know if you have any areas of expertise that might be of interest to the Mothers' Club:

11. Other ideas or suggestions you may have:

12. Email Address

13. Best Phone Number to Contact You: