JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
The version of the browser you are using is no longer supported. Please upgrade to a
supported browser
.
Dismiss
Untitled form
Send
Sign in
Untitled form
Questions
Responses
Section 1 of 1
Form title
Neighborhood Domain Name Application - preliminary / draft
Form description
The city of New York has reserved 350+ historic neighborhood names for development as public assets. If you are interested in applying for a license to use one of the city's neighborhood domain names to operate a local website - for example, Astoria.nyc, BrooklynHeights.nyc, Corona.nyc - complete this form. The goal of the Neighborhood Web Program is to make the digital equivalents of traditional neighborhood names available to local residents so that they may better connect and collaborate with one another. Note 1: Entities meeting the civic, management, and technical standards will be deemed qualified and granted a license to develop a neighborhood domain name. (See Neighborhood Domain Name Standards: https://docs.google.com/document/d/1OWpLrKV6ZPWIFDXGVJK-cOmiY83RMdzoZopC4E0HLW0/.) Note 2. There may be more than one applicant for a neighborhood name. In such instances a review process will determine which applicant merits award of the name. (See Neighborhood Domain Name Applicatin Review Process: https://docs.google.com/document/d/1feEu1Xs8kQHY7kfMuHwZEBPdMTWfrTM6zA_EWOFh0QY/.) Note 3. You will be able to return and edit this form. Background on the dotNeighborhoods project is available at http://www.coactivate.org/projects/campaign-for.nyc/traditional-neighborhood-names.
Email address
*
Valid email address
1. Neighborhood Name Requested
*
Title
1. Neighborhood Name Requested
*
Description (optional)
Loading...
Loading…
What neighborhood domain name are you applying for?
*
Question
What neighborhood domain name are you applying for?
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
(Select the neighborhood name from those listed on the following page: http://nyc-info.net/neighborhood-domains.pdf.)
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
Are there alternate domain names you would like to include in your request?
*
Question
Are there alternate domain names you would like to include in your request?
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
(For example, if you are applying for BedfordStuyvesant.nyc, you might also wish to request Bedford-Stuyvesant.nyc and BedStuy.nyc. NOTE: It is required that in instances of multiple name requests, that the alternate domain names point to the main domain name.)
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
2. Applicant Information
*
Title
2. Applicant Information
*
Description (optional)
This section collects general information about the applicant organization and the contact person responsible for completing this application.
Loading...
Loading…
What is the name of the applicant organization?
*
Question
What is the name of the applicant organization?
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
Applicant organization mailing address
*
Question
Applicant organization mailing address
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
(Enter the street number, street name, apartment or office #, neighborhood name, city, zip)
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
Name and title of the person responsible for completing the application.
*
Question
Name and title of the person responsible for completing the application.
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
(Enter the First-Name Last-Name and Title of the person responsible for completing this application.)
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
Your email address.
*
Question
Your email address.
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
(The email address of the person responsible for completing the application)
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
Your organization's Website URL
*
Question
Your organization's Website URL
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
(If you don't have a website, enter No Website.)
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
Is your organization a not-for-profit, a public benefit corporation, or local development corporation?
*
Question
Is your organization a not-for-profit, a public benefit corporation, or local development corporation?
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Yes
No
We have filed an application to become a public interest organization.
Other…
Other…
Add option
or
add "Other"
…
Select at least
Select at most
Select exactly
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
In what year was the organization formed?
*
Question
In what year was the organization formed?
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
3. Neighborhood Engagement Details
*
Title
3. Neighborhood Engagement Details
*
Description (optional)
This section seeks to ascertain the level of engagement the applicant organization has with the named neighborhood.
Loading...
Loading…
Is your organization's headquarters located in the neighborhood for which you are applying?
*
Question
Is your organization's headquarters located in the neighborhood for which you are applying?
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Yes
No
Other…
Add option
or
add "Other"
…
Select at least
Select at most
Select exactly
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
Who are the founders, directors, and officers of the applicant organization?
*
Question
Who are the founders, directors, and officers of the applicant organization?
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
(List the people responsible for originating this application and for guiding the organization's operation.)
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
What is the relationship between your organization and the neighborhood?
*
Question
What is the relationship between your organization and the neighborhood?
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
(Describe any historical relationship between the applicant organization and the neighborhood.)
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
What activities does your organization provide in the neighborhood?
*
Question
What activities does your organization provide in the neighborhood?
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
(Describe current or recent activities. If a newly formed organization, describe the types activities your founders have provided to the neighborhood.)
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
List neighborhood organizations that support your application.
*
Question
List neighborhood organizations that support your application.
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
(Please include contact informatin for an individual in each organization.)
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
List organizations that you will be partnering with in developing the domain and the roles they will assume.
*
Question
List organizations that you will be partnering with in developing the domain and the roles they will assume.
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
(For example, if you are partnering with a school for training purposed or linking to local blogs.)
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
What goals do you hope to achieve in developing this neighborhood domain?
*
Question
What goals do you hope to achieve in developing this neighborhood domain?
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
(Describe how you hope to help local businesses, civic organziations, other sectors, and individuals with access, training, creative services, etc..)
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Require a response in each row
Required
Required
Loading...
Loading…
Do you sponsor or support activities in other neighborhoods?
*
Question
Do you sponsor or support activities in other neighborhoods?
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
(Describe these activities and how much of your organization's budget, staff, and time are focused in neighborhoods other than the named neighborhood.)
Loading image…