Neighborhood Groups Questionairre

Please print and mail this form to Fairfax Volunteers, 142 Bolinas Road, Fairfax, CA 94930 or drop off the form at the Town Hall. Neighborhood Group activities will be ongoing and new participants are always welcome!

Fill out as much of the following information as you feel comfortable providing. We respect your privacy and so your responses will only be used for the Fairfax Volunteers database. When reporting on the Neighborhood Groups project, we will make public only combined statistics.

1. Choose Your Neighborhood(s):

Bothin
Cascades
Deer Park
Downtown
East End
Forrest
Manor
Marinda Oaks
MT&CC
Park
Rocca
Scenic Hill
West End
Willow
Other

Description of Other:


2. Check what you feel are the most relevant issues for your neighborhood and circle the most significant issue for you personally:

Pet Solutions
Open Space/Parks
Creek Health
Emergency Preparedness
Traffic Calming
Block Parties
Senior Issues
Home Improvement
Children’s Issues
Pesticide Spraying
Fire Prevention
Town Beautification
Development
Mosquito Abatement
Evacuation Plan
Festival Float Building
Parking
Disabled Neighbors
Bicycle Issues
Pedestrian Right-of-Ways

Describe any other issues in your neighborhood (use the back of this form if needed):


3. Who do you think would be a good contact person for your neighborhood?


4. Would you like to be notified about upcoming meetings, events, and issues? Bearing in mind that postage paid mailings are expensive and less timely than other forms of communication, also let us know how would you prefer to receive Neighborhood Group information:

No, thanks
Yes, by email
Yes, by phone
Yes, but I’ll check the website
Yes, by mail

5. We hope you’ll participate in creating a Neighborhood Group, but if you are not ready to be involved, may we contact you with information about our Legacy Projects?

No, thanks
Yes, by email
Yes, by phone
Yes, but I’ll check the website
Yes, by mail

6. Indicate which of our Legacy Projects you would consider helping with:

Stream Life Awareness Campaign
Pet Solutions
Public Renovation
Community Garden
Peri Park & Playground Maintenance
Creek Cleanup
Community Celebrations
 

7. Name/Others in your Household:


8. Phone Number(s):


9. Address:


10. Email:


Please print and mail this form to Fairfax Volunteers, 142 Bolinas Road, Fairfax, CA 94930 or drop off the form at the Town Hall. Neighborhood Group activities will be ongoing and new participants are always welcome!

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