Exit Weekly Survey - Reentry TO BE COMPLETED EACH WEEKEND (SAT/SUN) Question Title * 1. What is today's date? Today's Date Date Question Title * 2. Please provide your contact information? Name Address City/Town Email Address Phone Number Question Title * 3. Where do you work? Question Title * 4. How many hours did you work this week? Question Title * 5. How many hours of community service did your perform this week? Number of hours? Location? Question Title * 6. Upload your community service proof here. DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only. Choose File Choose File No file chosen Remove File Upload your community service proof here. Question Title * 7. Who is your Mentor? Question Title * 8. Did you speak with your mentor this week? Yes No Question Title * 9. Did you attend AA/NA meetings this week? Yes No N/A Question Title * 10. Do you have a sponsor? Yes No N/A If yes, who is your sponsor? Question Title * 11. What time do you attend Group Classes? Question Title * 12. Did you attend Group Class this week? Yes No SUBMIT