1. We are collecting information to help connect Milwaukeeans in Neighborhoods Groups and Workgroups - but will never share or abuse your personal information.
	Contact Name Neighborhood City Phone Number Email Address

	2. How did you hear about Transition Milwaukee, or the Transition Movement?
	Friend Event Media Urban Ecology Center Other Organization Flyer Facebook Twitter I can't remember Other, please specify

	3. Why did you originally become engaged with Transition Milwaukee?
	Just curious - to check it out or mull it over Personal Education To get involved For the network of people Just the basic excitement of it all Other, please specify

	4. What philosophical principle(s) resonates the most with you about the Transition Movement or Transition Milwaukee?  Choose all that apply.
	Resilience Relocalization Regenerative Sustainability Permaculture Community Engagement Graceful Descent Peak Oil Climate Change Economic Security Awareness Raising Reskilling Getting involved with Projects Becoming involved with your Neighborhood Initiative Beoming involved with a Workgroup or Taskforce Public Policy Other, please specify

	5. Please choose all of the 'Transitioning' topics that most interest you
	Food Soil Water Energy Shelter Transportation Radical Homemaking Consumerism Business/Economy/Currency Public Policy Health Bees Chickens Community Building The whole kit-n-kaboodle from above Other, please specify

	6. How has your experience with Transition Milwaukee been so far?  What are we doing well, and what can we improve upon?

	7. How would you like to see Transition Milwaukee evolve?

	8. What would most motivate you to get involved?

	9. Are you currently associated with an organization or a company that would be interested in a partnership with Transition Milwaukee?
	Yes or No If so, which one? Are you willing to serve as a liaison between Transition Milwaukee and your Partnering Organization? If not, whom within the organization may we contact?

	10. How would you like to be involved in Transition Milwaukee? (choose all that apply)
	Wall Flower - Observation Personal Education/Information and Tools Networking Meetings Projects Workgroups or Taskforces Neighborhood Groups - Strengthening my Community The Central Steering Committee (administration and catalyzation) Reskilling Partnering Organization Liaison Events - Awareness Raising or Tabling Other, please specify

	11. What skills, passions or interests do you have that you can contribute to Transitioning Milwaukee? (anything can apply - this is a skills assessment and does not stop at foraging or canning (desktop publishing, perhaps?)

	12. If you would like to get involved with Transition Milwaukee...can someone contact you? (we will never share or abuse your information - afterall, we're a bunch of do-gooders)
	Yeah - you bet! No Thanks Maybe later