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* 1. I understand the contact information I share will be made public for outreach purposes.

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* 2. Neighborhood Name:

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* 3. Contact Name:

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* 4. Telephone & Email Address:

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* 5. Boundaries of your Neighborhood (please be specific):

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* 6. My Neighborhood is:

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* 7. Please list Name and Email of the person interested in taking the role of President:

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* 8. Please list Name and Email of the person interested in taking the role of Treasurer:
*It cannot be the same person or 2 people from the same household

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* 9. At this time, does your group have a project(s) in mind? If so, please briefly describe.

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* 10. What is the intended impact of the project(s) on the Neighborhood?

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