Community Engagement Decision Making Form
Share your input and help shape decisions on this proposed initiative. Your feedback is valuable in guiding our community's direction.
Your Full Name
First Name
Last Name
Your Connection to the Community
*
Please Select
Resident
Local Business Owner
Community Organization Member
Visitor
Other
What is your overall opinion of the proposed initiative?
*
Strongly Support
Support
Neutral
Oppose
Strongly Oppose
Please share the main reasons for your opinion.
*
What benefits do you see this initiative bringing to the community?
Do you have any concerns or suggestions about the initiative?
How likely are you to participate or support this initiative if it moves forward?
Very Likely
Somewhat Likely
Unsure
Somewhat Unlikely
Very Unlikely
What is your age group?
Please Select
Under 18
18-24
25-34
35-44
45-54
55-64
65 or older
Prefer not to say
Zip Code (to understand local representation)
If you would like to be contacted for follow-up, please provide your email address.
example@example.com
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