About You Full Name* First Name Last Name E-mail* What City Do You Live In?* Are You...* SingleMarried Which age groups are represented in your household? * Select All That Apply Birth–PreschoolElementary SchoolMiddle SchoolHigh SchoolCollege or Young AdultAdults Without Children at HomeSeniors What is the Best Way to Communicate With You* Select All That Apply EmailText / WhatsAppWhatsApp GroupSocial Media Your Connection How Connected do You Currently Feel to the Jewish Community?* 1–10; 1 = Not connected at all; 10 = Extremely connected How Often do You Currently Participate in Chabad Programs?* WeeklyMonthlySeveral times a yearOnce or twice a yearI have attended in the past, but not recentlyI have not attended yet How Long Have You Been Connected With Chabad of Southlake?* I am new or have not yet attendedLess than one year1–3 years4–7 years8–10 yearsMore than 10 years Your Experience Which Chabad Programs Have You Attended?* Select All That Apply Community Shabbat DinnersShabbat Services and Kiddush LunchHoliday CelebrationsHebrew School of the ArtsCamp Gan IzzyCTeenCaring Kitchen of SouthlakeWomen's Events and ClassesMen's EventsAdult Education and JLIBagels, Lox & TefillinFamily and Children's ProgramsBook ClubLife-cycle celebrationsI have not attended a program yet Which Programs Would You Like to Attend More Often? Select All That Apply Community Shabbat DinnersShabbat Services and Kiddush LunchHoliday CelebrationsHebrew School of the ArtsCamp Gan IzzyCTeenCaring Kitchen of SouthlakeWomen's Events and ClassesMen's EventsAdult Education and JLIBagels, Lox & TefillinFamily and Children's ProgramsBook ClubLife-cycle celebrations Overall, how satisfied are you with your experiences at Chabad of Southlake?* 1–10; 1 = Not satisfied; 10 = Extremely satisfied Looking Ahead Which New or Expanded Programs Would Interest You? Select All That Apply Parenting workshopsMarriage and relationship enrichmentIsrael-focused programsJewish cooking classesBeginner Hebrew readingConversational HebrewJudaism 101Advanced Torah learningYoung professionals' programsYoung families' programsMoms' nights outWomen's wellness and social eventsMen's social nightsBusiness networkingJewish book clubTeen leadership opportunitiesCommunity service projectsMental health and wellness talksJewish travel experiencesIsrael tripsSenior programsMahjong game Which Days Are Generally Easiest For You? Select All That Apply SundayMondayTuesdayWednesdayThursday Which Times Generally Work Best For You? Select All That Apply MorningLunchtimeAfternoonEarly eveningEvening Helping You Participate What Sometimes Prevents You From Participating More Often? Select All That Apply Busy scheduleChildren's activitiesProgram timingDistance or travel timeCostChildcareTransportationI did not know about the programI do not know many peopleI am not sure whether the program is right for meHealth or accessibility needsNothing—I attend as often as I would like Is There Anything We Could Do To Make it Easier or More Comfortable for You to Participate? Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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