Name: _________________________________________________
Email Address: __________________________________________________
Mailing Address: __________________________________________________
Where did you grow up and what is your educational
background?
________________________________________________________
________________________________________________________
What is your occupation?
________________________________________________________
Are you working now?
________________________________________________________
Tell us about your lovely family (husband, children, pets,
etc…)?
________________________________________________________
________________________________________________________
What brought you to Kingwood? What village do you live in? What do
you like best about Kingwood? What would you like to see changed about Kingwood?
________________________________________________________
________________________________________________________
What activities do you enjoy (with and without children)? What
groups in MOYC, if any, do you participate?
________________________________________________________
________________________________________________________
Are you holding a position within MOYC (describe)?
________________________________________________________
Would you like to hold a position, what position would you enjoy?
________________________________________________________
What would you like to get out of MOYC this year? What can MOYC do
to help you achieve this goal?
________________________________________________________
________________________________________________________
Any other comments or interesting information:
________________________________________________________
________________________________________________________
