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* 1. Name:

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* 2. Professional Email:

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* 3. Organization:

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* 4. Title:

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* 5. What is your relationship to Ljubljana?

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* 6. Will you attend local OSAC meetings?

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* 7. Would you be willing to host OSAC meetings in Ljubljana?

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* 8. Are you interested in serving in a leadership role (either as co-chair or on the steering committee) for OSAC Ljubljana?

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* 9. Please check boxes of the topics that interest you and/or would be of benefit to your organization if covered at the next OSAC meeting:

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* 10. What is your preferred method of communication?

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* 11. How do you prefer to meet? (check all that apply)

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* 12. How often would you like to meet in person locally?

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* 13. What do you hope to gain from a local OSAC Ljubljana chapter?

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