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* 1. What is your first & last name?

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* 2. What is your email address?

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* 3. What is your zipcode?

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* 4. What is your season of life? Check all that apply

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* 5. If you have children at home, what age range are they? Check all that apply.

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* 6. What is the best day/time for you to meet? (check all that apply)

  early morning mid morning lunch time afternoon evening
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

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* 7. I am interested in getting together with: (check all that apply)

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* 8. I am interested in getting together with others who enjoy: (check all that apply)

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* 9. I am interested in these type of studies: (check all that apply)

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* 10. I prefer: (please check all that apply)

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* 11. I would participate in a retreat: (check all that apply)

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* 12. What would you most like to get out of a retreat/ reason for participating?

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* 13. What would you like the retreat to consist of? (check all that apply)

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* 14. What areas from this survey would you be willing to help facilitate?

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* 15. Please offer any comments or feedback on the idea of small groups at St. Matthew.

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* 16. What is your gender?

T