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* 1. What does CPAC do really well?

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* 2. What does CPAC need to work on for improvement?

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* 3. What services do you think CPAC should be providing that are not currently being provided?

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* 4. What other information would you like to share with CPAC?

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* 5. What role best describes you?

Parent

Educator

Administrator

Community Provider

Student/Youth

Other (please specify)

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* 6. Which race/ethnicity best describes you? (Please choose only one.)

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race

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* 7. What region of the state are you from?

Fairfield County

Hartford County

Litchfield County

Middlesex County

New London County

New Haven County

Tolland County

Windham County