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* 1. Name (First and Last Name)

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* 2. Email Address

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* 5. Please check the types of Alliance activities and projects which most interest you.

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* 6. Of the possible activities/projects listed in #5, please indicate which activities you are MOST interested in, and would possibly participate.

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* 7. What other activities/projects, not listed, are you interested in seeing the Alliance involved with?

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* 8. Please check the types of personal/professional development topics below which you find relevant and interesting.

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* 9. Please indicate which training topic(s) you checked in #8, that you are MOST interested in.

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* 10. What other types of training topics would you find interesting and useful?

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* 12. What days/times are most convenient for you to attend meetings and/or Alliance activities?  Check all that apply.

Thank you so much for your input.  This information will help the Town of Smithtown Youth & Community Alliance to prioritize their areas of focus.

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