19th Ward Community Association Survey
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Name  *
Best Method of Communication (please include phone #, or email as well)  *
Age of Person Filing out Survey  *
Children under 19? check all that apply  *
Required
Ethnicity/Race in household (check all that apply) *
Required
Current Employment Status (Check all that apply)  *
Required
What are some areas of interest for you/your household? *
Required
Do you identify as part of the LGBTQ+ Community  *
Are you interested in volunteering or being a part of our committees (MLK, Candlelight Dinners, Skating Party, Spelling Bee, Square Fair, Porch Fest, House Tours, Convention, etc)?   *
When are you able to volunteer? *
Required
Are you able to share any special skills?  *
Do you currently rent or own? *
Which social media platforms do you use? *
Required
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