Intake form

Name *

Email address *

What issues are most important to you in your community?

Please select at least one option.

Community improvement

Social justice

Local economic development

Public safety

Environmental sustainability

Affordable housing

Healthcare access

Education and youth programs

How do you prefer to engage with local initiatives?

Please select at least one option.

Community meetings

Online forums

Surveys

Social media

Volunteering

Donations

What is your preferred method of communication?

Are you interested in volunteering for the campaign?

What skills or resources can you contribute to the campaign?

Additional questions or comments

Shakhlo Sharipova