(401)j Got Shabbat: Guest Survey Question Title * 1. Please provide your contact information. Name: * City/Town: * State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming Email Address: * Phone Number: Question Title * 2. To what level do you celebrate Shabbat every week? Shabbat Observant every week I light the candles and sometimes go to or host a Shabbat dinner When I have a chance Other/Please Explain Question Title * 3. What kind of Shabbat meal experience would you prefer? PotLuck Home-cooked by host No Preference Other (please specify) Question Title * 4. Check all dietary restrictions that apply. Kosher Vegetarian Vegan Gluten-Free Other (please specify) Question Title * 5. Do you have any allergies we should know about? Yes No If yes. Please explain. Question Title * 6. Please identify the type of Shabbat experience you would feel most comfortable with. Check all that apply. Shabbat Observant Not Shabbat Observant Kosher Non-Kosher Please list any other experiences you are seeking. Question Title * 7. Would you drive to someone's house on Shabbat? Yes No If No, please provide a general location so we can match you with a host in your neighborhood. Question Title * 8. Would you use your cell phone or ring a doorbell on Shabbat to find the host residence? Yes No Please explain if necessary. Question Title * 9. Would you consider being a Got Shabbat host? Yes No Depends Other (please specify) Question Title * 10. Is there any additional feedback you would like to provide? Question Title * 11. Please indicate which dates you are able to attend as a guest for a Got Shabbat meal. (If you don't know for sure just list approximate availability and we will contact you to confirm). October 24, 2014 Any Shabbat works for me! Please list any specific dates that you are available for Shabbat dinner placement. Done
