Status: 
Active         Retiree     Family Member     Civilian     Contractor

Gender:
Male     Female  

Military Rank:            Military Branch:         

Marital Status: 

1.  Do the operating hours 0700-1630, M-F, meet your needs?    Yes         No

2.  Is the ACS office easy to find?    Yes         No

3.  What type of program/workshop/training are you interest in?  (Check all that apply).

4.  What is the best method for ACS to get information into the community? (check all that apply)
Email       Flyers    Bulletin Board    Website    Military mailings   Marquee
Other: 

5.   What is the best time for you to attend workshops? (check all that apply)
Mornings        Lunchtime     Afternoons     Evenings     Weekends

6.   What support groups would you use? (check all that apply)
Single Parent Group        Parents Support Group   Widowed Support Group
        Multicultural Spouses Group   Job Search/Networking Group   Waiting Spouse
        Family Readiness   Grandparents Support Group  
Exceptional Family Member Program Parent Group
Other: 
         
     
If you would like to be contacted regarding any of the above programs, please list your name, phone number, and email address below:
Name:     Phone:     
Email: 
                 

Form Complete (Y):