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RESIDENT APPLICATION
TO IDENTIFY SPECIFIC NEEDS IN THE CITY OF OXNARD
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Name (First & Last)
*
Your answer
Address
Your answer
Phone Number
*
Your answer
Email Address
Your answer
Location of Need
*
Your answer
Description of Need
*
Your answer
Type of Need
*
Public Service (Examples: healthcare, recreation programs, educational programs, services for senior citizens, services for homeless and fair housing activities)
Public Facility (Examples: improve street, sidewalks, and parks)
Infrastructure (Examples: improve water & sewer lines)
Housing (Examples: homeownership assistance, housing rehabilitation and code compliance)
Other:
Oxnard Resident
*
Yes
No
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