Immersion Trip Survey

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* 1. Name

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* 2. Which location did you visit?

Appalachia

Louisville

Belize

Kentucky (Louisville & Appalachia)

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* 3. Trip Start Date:

Date / Time

Date

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* 4. Group Name (if applicable):

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* 5. Please share your favorite lesson or personal memory from your trip.

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* 6. What would you say to someone considering this experience?

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* 7. Are there any activities you would have liked to have more of less of?

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* 8. How can we help you stay involved? (Check all that apply)

Would like a staff member to give a presentation to an organization, school, church, etc.

Assist in fundraising efforts

Receive an invitation to our Annual Fundraising Breakfast in Louisville in October

Consider a trip to Appalachia

Consider a trip to Belize

Consider a trip to Louisville

Consider a Kentucky trip with both a Louisville and an Appalachia trip

Contact me: My company will match funds/volunteer hours

Event or Office Volunteer (fundraising breakfast, minimal office tasks, etc)

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* 9. What is the best way to reach you for follow-up communications?

Phone

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* 1. Name

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* 2. Which location did you visit?

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* 3. Trip Start Date:

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* 4. Group Name (if applicable):

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* 5. Please share your favorite lesson or personal memory from your trip.

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* 6. What would you say to someone considering this experience?

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* 7. Are there any activities you would have liked to have more of less of?

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* 8. How can we help you stay involved? (Check all that apply)

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* 9. What is the best way to reach you for follow-up communications?

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* 10. Tell us anything else you'd like our staff to know!