Part I About your organization

 

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* 1. What is your organization's name?

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* 2. What is your address?

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* 3. What is your contact phone number?

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* 4. What is your email address?

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* 5. What is the name of the person completing this survey?

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* 6. Is your organization incorporated?

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* 7. What is your organization's geographic area? (choose one)

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* 8. What is your organization's PRIMARY purpose or function? (choose one)

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* 9. Which of the eight dimensions of a healthy lifestyle will your organization represent? (Check all that apply)