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* 1. Do you live in Crook County?

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* 2. Did this neighborly act of kindness help your neighborhood be safer, cleaner or friendlier?

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* 3. Based on this activity, do you think that it will generate addition acts of kindness?  Please explain.

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* 4. Was this act of kindness done by you or someone else?

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* 5. Please describe the act of kindness that was done.  If you have any photos, please email them to Info@CrookCountyFoundation.org (subject: Act of Kindness)

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* 6. Please provide your name, phone number, and email address

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* 7. If the act of kindness was done another someone other than yourself, please provide us as much contact information for this person as possible (name, phone number, email, etc)

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