Imagine Different Coalition Members: We need to utilize all Coalition members talents to best advantage. This survey will help to identify your interests and ways that you can contribute to the success of the Coalition. This information will make it possible to have a well-coordinated impact across systems. Please share the opportunities you have to advance the work of the coalition and share your ideas.

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. Identify topic areas and/or issues that you would like to participate in. CHECK ALL THAT APPLY, ADD ANY OTHERS

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* 4. Identify activities you would be willing to do, both External and Internal:

Thank you so much for sharing your input. We will work with everyone's input at our meeting on November 16th. Hope to see you there.

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