Brooklyn Community Board 9 - Resident Member Committee Application

Question Title

* 1. Personal / Contact Information

Name

Address 1 (Street Address - incl. Apt/Unit # if applicable)

Address 2 (City, State, Zip Code)

Email Address

Phone Number

Question Title

* 2. Committee Choice - First Preference

Economic Development

Education

Environmental Protection

Health & Social Services

Housing

Parks, Recreation & Culture

Public Safety

Transportation

ULURP/Land Use

Youth Services

Question Title

* 3. Committee Choice - Second Preference

Economic Development

Education

Environmental Protection

Health & Social Services

Housing

Parks, Recreation & Culture

Public Safety

Transportation

ULURP/Land Use

Youth Services

Question Title

* 4. Committee Choice - Third Preference

Economic Development

Education

Environmental Protection

Health & Social Services

Housing

Parks, Recreation & Culture

Public Safety

Transportation

ULURP/Land Use

Youth Services

Question Title

* 5. Have you previously participated in any of Brooklyn Community Board 9 Committees?

Yes

No

Question Title

* 6. Please describe your interest in participating at Brooklyn Community Board 9. Also include any skills or qualifications that you feel may be useful to the Board.