CTIC Membership Survey (Community Transition Inter

Agency's Name:

Agency Participants

* First Name :

* Last Name :

* Address 1 :

Address 2 :

* City :

* State :

* Zip :

* Phone :

* Email Address :

Is the location of the meetings, the #206 District Offices, a convenient place for your or someone from your agency to get to in order to attend the meetings?

Very Likely

Somewhat Likely

Very Unlikely

Are there topical areas that you feel need to be addressed that are presently not be addresses which would make your attendance more applicable?

Very Likely

Somewhat Likely

Very Unlikely

Other

Is the time of the meeting a convenient time for you or your agency? The meetings have been at 3:00 in the afternoon. Is this a convenient time to meet?

Very Likely

Somewhat Likely

Very Unlikely

If not, is there a better time?

Early morning

Mid-morning

During Lunch

Early afternoon

The next meeting has been scheduled for October 23rd at 3:00 pm. Will you or another representative from your agency be able to participate?

Very Likely

Somewhat Likely

Very Unlikely

The CTIC Committee has established a future date of February 21, 2013 to host a Transition Expo from 5:00 - 8:00 pm at the Alexandria High School Commons/Cafeteria. Will your agency be willing to participate on this date, and set-up a table display with the information from your agency?

Comments/Suggestions: