2020 End of Year Program Feedback

1
Name (please enter as you would like to see printed in chapter directory)* This field is required.
First Name
Middle Name
Last Name
Suffix
2
Email (please enter as you would like to see printed in chapter directory)
example@example.com
3
Address (please enter as you would like to see printed in chapter directory)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
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Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
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Burundi
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Canada
Cape Verde
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Chad
Chile
China
Christmas Island
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Colombia
Comoros
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Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
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Democratic Republic of the Congo
Denmark
Djibouti
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Ecuador
Egypt
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Ethiopia
Falkland Islands
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Finland
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The Gambia
Georgia
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Greece
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Hong Kong
Hungary
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India
Indonesia
Iran
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Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
Phone Number (please enter as you would like to see printed in chapter directory)
Area Code
Phone Number
5
Name of Spouse or Partner (please enter as you would like to see printed in chapter directory)
Prefix
First Name
Last Name
Suffix
6
Family Information
7
Please submit a family photo for our chapter directory and program handbook
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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8
What Grade Group(s) are you representing?
Little Legacies/Little Dynamites
Shining Stars
High Flyers
Junior Teens
Senior Teens
9
Was programming developmentally appropriate for your child or children?
Yes
No
10
Are there any specific Grade Group/Chapter Programming activities that you would like to have again?
11
I recommend the following improvements for Grade Group/Chapter Programming activities for the 2020-2021.
12
Are there any specific Grade Group/Chapter Programming activities that you would prefer not to have again?
13
Overall, how would you rate programming for the 2019-2020 year?
1
2
3
4
5
14
Select a committee to serve on during the 2020-2021 Programming Year.* This field is required.
Archives
Audit
Budget
Bylaws
Communications
Publicity
Education
Fundraising
Health
Legislative
Membership
Associates
Father's Auxiliary
Hospitality
Social
Programming
Service
Five Star
Grievance
Legal Review
Strategic Planning
Technology
35th Anniversary
15
Select a committee to serve on during the 2020-2021 Programming Year.* This field is required.
Archives
Audit
Budget
Bylaws
Communications
Publicity
Education
Fundraising
Health
Legislative
Membership
Associates
Father's Auxiliary
Hospitality
Social
Programming
Service
Five Star
Grievance
Legal Review
Strategic Planning
Technology
35th Anniversary
16
Select a committee to serve on during the 2020-2021 Programming Year.
Archives
Audit
Budget
Bylaws
Communications
Publicity
Education
Fundraising
Health
Legislative
Membership
Associates
Father's Auxiliary
Hospitality
Social
Programming
Service
Five Star
Grievance
Legal Review
Strategic Planning
Technology
35th Anniversary
17
Would you like to serve as a committee chair? If so, please indicate which committee.
Yes
No
Other
18
Please add the information for your entire family below. Include each family member's name, grade, they type of service (disaster relief, hunger/homelessness, environment, literacy/education, elderly assistance, health, public safety violence, youth serving youth). Please note that it must be done June 1 - May 15th of this programming year. Please see the Granite Gazette for specifics.
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