Use "Print" command on browser to print out this form

Academy for Lifelong Learning of Cape Cod, Inc.

Members Information Survey – Fall 2008

 

Please help us get to know you better by providing the information below.  Please complete and return it with your registration form.

 

Name_______________________________________            Phone______________________

 

Address (Street # and Town) _____________________________________________________________________           

 

email (will not be shared)________________________________________________________________________

 

1.         I am____ New Member            _____Current, Since____________

                        (Check one)

 

2.         Primary Vocation or Avocation______________________________________________

 

3.         Have you coordinated/led classes     (at ALL or elsewhere)?   _____Y            _____N

           

            Subject___________________   Where____________________   Level___________

 

4.         Would you like to co-ordinate/lead a course for A.L.L.?             _____Y            _____N

             

            What type of course______________________________________________________

 

5.         What course subjects would you like A.L.L. to conduct NOT INCLUDED in the Spring Catalog?

            ______________________________________________________________________

            ______________________________________________________________________

 

 6.       Complete the following:  If Current member  (place X)  IF Interested (place √ )

 

Click for brief description of the following choices
___Curriculum ___Newsletter ___Public Relations ___Office Help
___Long Range Plan ___Registration ___Ways & Means ___ALL Magazine
___Membership ___Arts Showcase ___Special Events ___Hospitality
___Policy Procedure ___Fund Raising ___Nominating ___Word Processing
___Other  We welcome your ideas and suggestions.  Please feel free to attach additional information sheets.
____________________________________________________________________________________
____________________________________________________________________________________

               

Thank you for your cooperation.

Return Home