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* 1. What is your name?

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* 2. What agency do you work for?

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* 3. What is your email address?

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* 4. What is your role in WIC?

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* 5. How familiar are you with the works of the Missouri WIC Association?

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* 6. Which of the following are you aware of? Select all that apply.

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* 7. Would you be interested in learning more about becoming an active member of MWA?

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* 8. What do you anticipate being a barrier for you to being an active member of MWA?

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* 9. What would you like to see from MWA in the future?

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* 10. Please leave any other comments/questions you have about MWA.

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