Community Discussion Survey
Ambridge Connection with the help of the Pittsburgh Media Partnership is looking to host a series of conversations between different groups of people. We need to know there are members of the community who want to be part of the discussion. If you are interested in moving forward and participating, please fill out the survey. This is an opportunity to discuss the area's experience with COVID-19, recent protests, and any other important issues.

Filling out this form does not guarantee you a spot.
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If we move forward with a community discussion it will be recorded. Are you willing to be seen on video? *
First and Last name *
Phone number (digits only) *
Email *
What community do you live in? *
Pick only categories you can speak from as your viewpoint (choose one or more): *
Required
Which discussion is your first choice to sit in on and be a part of the conversation? (pick one and please note you might not be chosen for the one you choose or at all depending on availability) *
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