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* 1. First Name:

* 2. Last Name:

* 3. ZIP Code:

* 4. Your children's names:

* 5. and ages:

* 6. In terms of being Jewish, how would you describe yourself today?

* 7. Are you or your children current BBYO members or alumni?

* 8. Has your family ever attended a family camp program?

* 9. If so, what camp/organization hosted the family camp?

* 10. If BBYO offered a family camp program built around the same core values as BBYO's other programs, would your family be interested in attending?

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