CSOC Connection Session interest form Survey

1.Your name(Required.)

2.Your email address(Required.)

3.Your organization(Required.)

4.Your role(Required.)

5.Date of the session you're planning to attend(Required.)

Date / Time

Date

SuSunday

MoMonday

TuTuesday

WeWednesday

ThThursday

FrFriday

SaSaturday

6.Have you attended an ANJ statewide connection session before?(Required.)

Yes

No

I don't remember

7.What questions do you have for us?(Required.)

8.These CSOC connection sessions are ONLY for CSOC system partners or CSOC employees.(Required.)

I am an employee of a CSOC system partner agency or CSOC itself

I am not part of a CSOC system partner agency or CSOC itself (note: if you select this option, you should not attend the connection session)

9.Please add any additional comments, concerns, suggestions, etc.