YOUR GROUP

QUESTIONNAIRE:
SHARE SOMETHING ABOUT YOUR GROUP

For current, past or multiple groups
Sharing your stories will help so many others.
Most fields are not required, we wanted you to be free to choose.
Required fields are marked with an asterisk *

Your Group

Today’s Date

Name

First

Last

How did you learn about the STC Model?

Pick one below - Is your group:

Currently Active

Previously Active

Address

City

State/Province

Zip/Postal

Country

What is/was the challenge of your care recipient?

Approximate age of care recipient?

How many people are in your group?

Did/Does your Group have a special name?

Please share a story (or stories) about your group or something you all were proud to have accomplished.

Written/Photos/Videos/Audios are all welcome. Group photo or individuals doing something with your care recipient. An event you had or poems, songs, etc.

Maximum file size: 125.83MB

What piece of advice would you pass on to other groups?

What was the most rewarding aspect of working with your group?

What was the least favorite aspect of working with your group?

We’d love for everyone in your group to receive our quarterly Newsletter or special news as it happens. Please ask them to join our mailing list or add their emails below and we will add them.

Have you or others in your group suggested STC to other people who might benefit?

Yes

Anything else you want to tell us would be great.

If you are human, leave this field blank.

YOUR GROUP

QUESTIONNAIRE: SHARE SOMETHING ABOUT YOUR GROUP

QUESTIONNAIRE:
SHARE SOMETHING ABOUT YOUR GROUP