* 1. First and Last Name

* 2. Email

* 3. Address

* 4. Age Range

* 5. How many years have you lived in Claremont?

* 6. What kind of Quality of Life Project would you like to see the City of Claremont invest in? Please rank your choices with #1 being your top choice.

* 7. Other Quality of Life Project Suggestions:

* 8. Would you like to be involved in future events and projects, like Claremont Daze or Quality of Life, as a volunteer?

* 9. Would you like to receive information about the City and it's events throughout the year?