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* 1. Do you identify as:

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* 2. Are you a:

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* 3. How likely are you to participate with this activity-Social Services: Feeding the homeless or feeding seniors?

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* 4. How likely are you to participate with this activity-Education and Literacy: (ie: bookshare boxes in the community or synopsis/book club)?

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* 5. How likely are you to attend a block party or block event in your neighborhood?

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* 6. Do you know your neighbors?

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* 7. If you want to propose an activity for consideration, please provide details and your contact information.

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