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* 1. Where would you like the book club to be held? 

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* 2. How often would you like the book club to meet?

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* 3. Which day(s) are you available to attend book club meetings?

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* 4. What time(s) are you available to attend book club meetings (please check all that apply)

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* 5. What types of books are you interested in reading? Check all that apply.

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* 6. Please share any other comments you would like us to know regarding book clubs.

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* 7. If you would like us to contact you with updates about the book club by email please provide your name and email address in the boxes below.

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* 8. If you would like us to contact you with updates about the book club by phone please provide your name and phone number in the boxes below.

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