Concord 101 2019 Application - due July 26!
Class size is limited, and preference is given to City of Concord residents. Applications accepted until July 26, 2019.

Class schedule and printable application available at http://www.concordnc.gov/Resident/Concord-101.

Last Name *
Your answer
First Name *
Your answer
Home street address *
Your answer
Reside in Concord City Limits? *
Zip Code *
Your answer
Primary phone number *
Your answer
Email address *
Your answer
How long have you resided in Concord? *
Your answer
Occupation *
Your answer
Educational background: *
Your answer
Why are you interested in Concord 101? *
Your answer
Other past or present community activities:
Your answer
Past City government service or involvement (such as serving on a board), if any:
Your answer
Are you available for weekly Tuesday* meetings from 6:15 p.m.-8:30 p.m.? *
If offered, would you instead prefer the option of weekly Tuesday meetings from 2:00 p.m.-4:15 p.m.? *
Please check the box to verify that you are 18 years of age or older. *
Required
Notice: The City of Concord does not discriminate on the basis of age, sex, race, religion, national origin, or disabilities. If anyone needs special accommodations, please contact Peter Franzese at franzese@concordnc.gov. This application may be available in an alternate format for users with special needs.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service