* 1. Contact Information

* 2. Would you prefer to join a Chavurah with (check all that apply)

* 3. What type of demographic groups would you like to participate in? (check all that apply)

* 4. In which social or outdoor activities listed below would you like to participate? (check all that apply)

* 5. In which of the following educational or cultural activities would you like to participate? (Check all that apply)

* 6. Would you like to suggest a group? If so, what group(s)

* 7. Would you like to organize the first leading of your Chavurah?

* 8. Is there anything else you would like the Chavurah Committee to know?

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