Thank you in advance for taking this survey which will help our Boulder Jewish community better understand the needs of individuals with disabilities, mental health challenges or other special needs. Your comments, insights and suggestions will guide us in our efforts to evolve into a truly inclusive Boulder Jewish community. We strive to become more inclusive so that everyone will feel welcome, comfortable, and able to participate at our various events and religious services. This initiative is a volunteer-driven coalition of interested synagogues and organizations.

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* 1. Tell us a little about yourself. Please check as many as apply.

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* 2. If a family member has special needs, how is this person related to you?

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* 3. What age is the individual(s) with special needs identified above?

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* 4. What kind of accommodations would benefit the individual(s) with special needs identified above? Please check as many as apply.

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* 5. What types of programming would you or your family attend if the desired accommodations were made?

  Would attend and help organize Would likely attend Would possibly attend Would not attend N/A
Hebrew School or tutoring for students with special needs
Participation in main synagogue services with accommodations for special needs
“No Shushing” Shabbat / High Holiday services (where everyone can feel comfortable to move about or make noise)
Small group Shabbat / holiday services
Partnership with another Jewish adult/family to celebrate Shabbat / holidays at home
Community events with accommodations for special needs
Guest speakers about inclusion-related topics
Workshops/trainings about inclusion-related topics
Chavura (group with similar interests)
Jewish Parent Support Group
Dads' Support Group
Sibling Support Group
Support Groups for children with specific disabilities
Support Groups for adults with specific disabilities
Other Support Group (please explain below)

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* 6. Are you affiliated with any Jewish organizations in the area? Please check as many as apply.

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* 7. Are you affiliated with any special needs organizations in the area? Please check as many as apply.

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* 8. Are you affiliated with or have you or a family member attended (currently or in the past) any educational organizations or camps in the area? Please check as many as apply.

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* 9. Please add any additional comments or suggestions.

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* 10. Optional: Add your email address if you'd like to hear more about inclusion events in the Boulder Jewish community and/or help with programming suggested above. OR email BoulderJewishInclusionSurvey@gmail.com

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