Columbia Council of Neighborhoods Neighborhood Certification Form

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All neighborhoods must certify their neighborhood each July 1 and update officer information as needed.

Email *

This form is: *

Annual Certification

Update to Annual Certification

Neighborhood Organization Name *

Neighborhood Permanent Address *

Neighborhood Zip Code *

Does your neighborhood have an EIN# (Required to receive city and CCN grants)? If you need assistance acquiring an EIN, see a member of the CCN Executive Committee. *

Yes

Neighborhood EIN# (required to receive funding from CCN)

Neighborhood Street Boundaries (List all street names) *

What portion of your neighborhood lies within city limits of Columbia? *

All

Mostly

Less than half

Name of President *

Email of President *

Mobile Phone # of President *

Name of Vice-President

Email of Vice-President

Mobile Phone # of Vice-President

Name of Secretary

Email of Secretary

Mobile Phone # of Secretary

Name of Treasurer

Email of Treasurer

Mobile Phone # of Treasurer

Name of Appointee to Attend and Vote at CCN Meetings (if this is president, indicate n/a) *

Email of Appointee

Mobile Phone # of Appointee

When does your neighborhood meet (ex. first Monday at 6 pm)? *

When do you elect officers (ex. Annual Meeting in November)? *

Form Submitted By: *

Date of Submission *

YYYY

A copy of your responses will be emailed to the address you provided.

Submit

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