JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Zero In Bloomington Outreach & Inquiry Form
If you or your community group are interested in hosting a workshop, running a challenge, or learning more about how to get involved with Zero In Bloomington, please fill out and submit the following form.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name
*
Your answer
Email
*
Your answer
Are you reaching out as the representative of an organization/community group or as an individual
?
*
Organization/Community Group
Individual
If you are representing an organization/community group, please list the name of your organization/community group here.
Your answer
Have you/your organization already registered on Zero In Bloomington?
*
Yes
No
How can we help you get involved?
*
Registration assistance
Planning a group challenge or initiative
General orientation of the site
Other
Please describe the nature of your interest/inquiry.
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of City of Bloomington, Indiana.
Report Abuse
Forms
