First Name*

Last Name*

Email Address*

Your County ward or closest village (i.e. Ameliasburg / Cherry Valley / Waupoos?) *

How many years have you lived in The County? *optional*

Please describe your earliest and/or fondest County memory. (i.e. who/what/when/where/why/how) *optional*

Tell me about the County program/project/non-profit you are involved with. *

What excites you the most about this program/project/non-profit? Please describe. *optional*

In your experience, how is this program/project/non-profit improving local lives? *optional*

Why do you choose to participate in and/or support this County program/project/non-profit? *optional*

How is this program/project/non-profit taking a creative approach to making a difference in our County? (please feel free to elaborate if you'd like) *optional*

What matters most to you about this program/project/non-profit? Why? *optional*

Please tell me about an awesome experience you’ve had as a result of your participation. (i.e. meeting new people, sharing your expertise, understanding more about the County, etc. ) *optional*

In your opinion, why should people support this program/project/non-profit? *optional*

Other: Your comments, feedback, and insights are welcome. Thank you!