My Neighbor's Voice Survey
Host
Your answer
Moderator
Your answer
Dinner Date *
MM
/
DD
/
YYYY
Thank you so much for participating in My Neighbor’s Voice dinner gathering. Please

take a moment and complete this survey. The more you share with us, the better future

community experiences will be.

1. Which question(s) or topic(s) interested you most? Why?
Your answer
2. Did any answers surprise you or challenge your thinking?
Your answer
3. Was there a question that you wish you could have answered?
Your answer
4. If you could now add or clarify something you said, what would it be?
Your answer
5. How would you describe your overall experience to someone who had never participated in My Neighbor’s Voice?
Your answer
6. Do you believe that listening to your neighbor will have a positive impact on our community?
Your answer
7. Did your host and moderator create a safe and hospitable setting for the event? If not, PLEASE explain or provide suggestions.
Your answer
8. Would you participate in another My Neighbor’s Voice event?
9. Would you be willing to host a gathering?
10. Would you be willing to train to become a moderator?
Name (optional)
Your answer
Contact Information (optional)
Your answer
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