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Sunday, October 17, 2010

CARE Interest Survey


CHURCH ASSISTANCE & RECOVERY EDUCATION
PROGRAMS


INTEREST SURVEY


C.A.R.E. Programs are designed to help meet the needs of members in our community. Please review this survey and let us know which programs you have interest in.



Programs
I Would
Like More Information
On This
I May Be
Interested
In Helping
With This
I Have Experience
Helping
With This
I Have
Good Information
About This
Alcohol Addiction
Drug Addiction
Tobacco Addiction
Anger Management
Grief Counseling
Clothing Closet
Food Pantry
Shelter Assistance
Financial Assistance
Weight Loss
Marriage Counseling
Parenting Counseling
Divorce Support Group
Care-Taker Support Group
Alzheimer’s Support Group
Cancer Support Group
Diabetic Support Group
Senior Citizen Activities
Teen / Youth Activities
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* Please list on the back of this page any other programs you would like to see offered.
Name _________________________________________ Phone # ____________________
Address________________________________________ Cell # ____________________
________________________________________ FAX # ____________________
E-Mail ______________________________________________
How would you like to be contacted? ___ Phone, ___ Cell, ___ FAX, ___ Mail, ___ E-Mail