Bronx SWAB Membership Application Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This form has 4 sections and will take about 15 minutes to complete. Please fill it out if you are interested in becoming a SWAB member. If you have any questions feel free to email us at bronxswab@gmail.com.

Name *

Physical Address *

Email *

Phone Number *

Are you currently a member of any other borough’s Solid Waste Advisory Board (not the Citywide Recycling Advisory Board)?

Yes

Clear selection

Do you work for the City of New York in any capacity?

Yes

Clear selection

If ‘yes,’ which agency?

Do you have an affiliation with any organizations? Please list them all below.

In which Bronx neighborhood do you work/reside (zip code is acceptable)?

In which Bronx Community Board do you work/reside (visit http://www.mygovnyc.org/ to find out)?

Community Board 1

Community Board 2

Community Board 3

Community Board 4

Community Board 5

Community Board 6

Community Board 7

Community Board 8

Community Board 9

Community Board 10

Community Board 11

Community Board 12

Clear selection

Have you ever been a member of a Community Board?

Yes

Clear selection

If yes, please specify the borough, the Community Board and dates of service:

NYC Administrative Code: Confirm that you are familiar with solid waste advisory board membership conditions and board functions as described in Sections 16-317 and 16-318 as well as the disclosure statement pursuant to Section 16-321 (Subchapter 4 of Chapter 3 of Title 16 of the New York Administrative Code) by typing "Yes". If applicable, also provide details of your disclosure below. (Sections linked here: https://nycadmincode.readthedocs.io/t16/c03/sch04/ and https://www1.nyc.gov/assets/coib/downloads/pdf2/books/chapter-68.pdf) *

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms