MWA Afternoon Tea Luncheon

Community Input Evening

6:00-8:00 pm at the Mills Community House (3rd level)
Which evening will you join us*

Friday, January 16Saturday, February 7thI am unable to attend either evening
We are sorry to hear that you cannot make our event, but are grateful that you let us know. If you are willing to share your thoughts and ideas with us, we would appreciate your time and input through our survey (link below) that we made to help us measure impact, learn about areas we can improve, and gather ideas for the future.

Cognition Community Input Survey
Name*

First NameLast Name
E-mail*
Phone Number

Area CodePhone Number
How many guests will be in your party?*
Would you like to register any kids for the simultaneous program at Cognition?*

YesMaybeNo
Child Information

Kids may be brought to Cognition as early as 5:30 before the Input Gathering begins and picked up by 8:30. This is a free drop-off program so parents may attend the event. We will have pizza and juice and special supervised activities.
Child #1
Name
Child #1's Age
Add another Child
Child #2
Name
Child #2's Age
Add another Child
Child #3
Name
Child #3's Age
Add another Child
Child #4
Name
Child #4's Age
Add another Child
Child #5
Name
Child #5's Age
Add another Child
Child #6
Name
Child #6's Age
Should be Empty:

Community Input Evening