AH: Breath of Life Questionnaire


QUESTIONNAIRE
Thank you for taking the time to fill out this brief questionnaire and for sharing your thoughts with us! Answer only those questions you wish; but your thoroughness helps us to better evaluate the Sangha's programs, needs and talents. Namaste!


*Name:*
*Email address:*
*Telephone:*
*Age:*
*Gender:*

*Ethnicity:*	White/Caucasian (non-Latino) Black/African American Asian/Pacific Islander Native American/Alaskan Native Latino/Hispanic Other:

*How would you describe your orientation?*
	Heterosexual GLBT Other:

*Please briefly describe both your past religious or spiritual background and your current path:*


*Would you be interested in taking part in monthly "mini-sanghas" associated with "Awakening Heart" (Community of Mindful Living)?*


*Check any of the following "mini-sangha" groups that you would be interested in:*
	Diving Deeper (w/Monica & Br. ChiSing) Buddhist Book Club Christian Meditation Unity Church Science of Mind 12-Step Recovery Other:

*Would you be interested in becoming trained as a "mini-sangha" facilitator?*


*Would you be interested in coming to "Gentle Yoga" classes from 4-5 pm on Sundays before meditation at 5:30 pm? (perhaps starting in June)*


*Check any of the following skills, abilities, and volunteer opportunities that you would be willing to offer to contribute to the Sangha:*
	Guitar Other instrument: Childcare during Sangha Set-up from 4-5 pm on Sundays Videography Other:

*Any additional comments or suggestions:*