2. First Name
3. Last Name
5. Street Number
6. Street Name
7. Street Type
9. Phone Number
10. Text?

    1. Yes
    2. No
11. Email
13. How long have you lived in your neighborhood?
14. Do you rent or own?
    -- Select One --RentOwn
15. How would you describe the "atmosphere" of your neighborhood?
    -- Select One --Well-keptMediocreRun down
16. Do you feel like you are part of the neighborhood?
    -- Select One --YesNo
20. Rate concerns you have for your neighborhood
22. Crime

    1. Very Concerned

    1. Somewhat Concerned

    1. Not Concerned

    1. Don't Know
24. Speeding

    1. Very Concerned

    1. Somewhat Concerned

    1. Not Concerned

    1. Don't Know
26. Vandalism / Graffiti

    1. Very Concerned

    1. Somewhat Concerned

    1. Not Concerned

    1. Don't Know
28. Unkempt yards

    1. Very Concerned

    1. Somewhat Concerned

    1. Not Concerned

    1. Don't Know
30. Inoperable vehicles

    1. Very concerned

    1. Somewhat concerned

    1. Not concerned

    1. Don't Know
32. Roads \ sidewalks

    1. Very Concerned

    1. Somewhat Concerned

    1. Not Concerned

    1. Don't Know
34. Bicycle lanes

    1. Very Concerned

    1. Somewhat Concerned

    1. Not Concerned

    1. Don't Know
36. Street lighting

    1. Very Concerned

    1. Somewhat Concerned

    1. Not Concerned

    1. Don't Know
40. How are public services in your neighborhood?
42. Police and Fire protection

    1. Good
    2. Fair
    3. Poor
43. Street repair \ maintenance

    1. Good
    2. Fair
    3. Poor
44. Trash collection \ recycling

    1. Good
    2. Fair
    3. Poor
45. Park maintenance

    1. Good
    2. Fair
    3. Poor
47. Recreation

    1. Good
    2. Fair
    3. Poor
49. Is there a city serives that your neighborhood needs that is not being provided?

    1. Yes
    2. No
50. Identify needed service
54. A neighborhood watch group is forming in your neighborhood. Are you interested in becoming involved?
56. Crime Watch Block Captain

    1. Yes
    2. No
57. Making reminder calls / texts for meetings?

    1. Yes
    2. No
58. Distributing Neighborhood Information?

    1. Yes
    2. No
59. Attend City Council meetings

    1. Yes
    2. No
61. What days and time work best for you to meet with your neighbors for a Crime Watch Meeting?
    Preferred day and time
62. What type of neighborhood communication would be helpful in getting information to you?

    Check all that apply

    1. Newsletter
    2. Neighborhood Website (Nextdoor/ Facebook)
    3. Text Message
64. Other ideas:
66. Thank you.
Leave This Blank:


68. 1. Receive an email copy of this form.
69. Email address

    This field is not part of the form submission.

70. Submit

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