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* 1. What is your name and email address?

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* 2. Name/Description/Vision of Missional Community:

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* 3. Who are the other leaders/people invested in your Missional Community? (Please provide names and email addresses if anyone you think should be included in future Missional Community gatherings/trainings.)

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* 4. When did your Missional Community begin?

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* 5. Is your Missional Community still gathering?  If so, describe your community rhythms. If you are no longer gathering, please explain why.

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* 6. How many people are/were a part of your Missional Community? (Leaders, engaged community, etc.)

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* 7. Did you participate in any UPC trainings/missional community cohorts (ie. Tangible Kingdom, TK Remix, Incubator, etc.)?  If yes, what were the most significant take-aways?  How did this inform/impact your Missional Community?

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* 8. What have been the highlights of your Missional Community experience?  What have been the challenges?

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* 9. What further resources would you like to have from UPC?  What do you think would help to encourage or equip you or other leaders?

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* 10. Is there anything else you would like to share about your Missional Community experience?

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