Raleigh Neighborhood Registry

Raleigh Neighborhood Registry Application

Thank you for your interest in the Raleigh Neighborhood Registry, the official list of neighborhood-based organizations in our city. For assistance or information, please call the City of Raleigh Community Engagement Division at 919-996-4330.

In addition to the information below, we request that you provide a map showing the boundaries of the area your organization represents. The map can be hand drawn or it can be a photocopy with the boundaries highlighted. Please mail the map to City of Raleigh Community Engagement Division, P.O Box 590, Raleigh, NC 27602; email it to jonathan.edwards@raleighnc.gov; or fax it to 919-996-7982

(Please note: All information you provide on this form is public record under the North Carolina Public Records law.)

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* 1. Name of your organization:

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* 2. Date formed:

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* 3. Number of homes:

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* 4. Approximate number of people represented by the organizaton:

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* 5. Which Citizens Advisory Council (CAC) represents your neighborhood?

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* 6. Main contact person for your organization. (The person listed here will receive CAC newsletters.)

Name:

Title:

Mailing Address:

ZIP:

Email Address:

Day Phone Number:

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* 7. Which is the best way for this contact person to receive information?

U.S. Postal Service

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* 8. Other representative of officer:

Name:

Title:

Mailing Address:

ZIP:

Email Address:

Day Phone Number:

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* 9. Other representative or officer:

Name:

Title:

Mailing Address:

ZIP:

Email Address:

Day Phone Number:

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* 10. When does your organization elect officers? (For example, the first Thursday in January.)

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* 11. This organization is a:

Other (please specify):

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* 12. How often does the organization meet?

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* 13. Is membership open to anyone who lives or owns property in the neighborhood, regardless of race, religion, color, sex, age, national origin or physical or mental ability?

Yes

If no, please explain:

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* 14. Please provide a brief statement of the organization's objectives and goals.

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* 15. What are the major activities of your organization?

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* 16. How did you hear about the Raleigh Neighborhood Registry?

Other (please specify)

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* 17. Information about person completing this form:

Name:

Title:

Mailing Address:

ZIP:

Email Address:

Day Phone Number:

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* 18. Do you authorize the City of Raleigh to place contact information for your organization on its website? (Having this information on the website will improve your ability to network with residents of your neighborhood and with other neighborhood groups.)

Yes