Community Membership Form

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Every movement gains strength in numbers. Every number has a face -- starting with yours!

What are you prepared to do to help the community coalition in Greater Riverdale? (Check all that apply) *

I would like to become a member of the community coalition.

I would like to recommend members for the community coalition.

I am interested in serving on the steering committee of the community coalition.

I am willing to provide letters of support for future coalition initiatives.

My organization would like to serve as a community coalition partner.

My organization is open to sponsoring future initiatives of the community coalition.

My organization will lend space to the community coalition for ongoing efforts when it is safe to do so.

My business is willing to offer future discounts for members of the community coalition.

I would like to learn more about serving as a chair or co-chair of a workgroup.

I would like to learn more about volunteering as a member of a workgroup.

Other:

Required

Name *

First and last name

Organization/Affiliation (if applicable)

Email *

Phone number *

Are you a resident of Greater Riverdale? *

Yes

Which Greater Riverdale community do you represent? (Check all that apply) *

I do not represent a particular community or neighborhood in Greater Riverdale.

I represent the entire Greater Riverdale community.

Town of Riverdale Park

Riverdale Hills

Riverdale Heights

Madison Hills

Crestwood

Eastpines

Templeton Knolls

Hanson Oaks

West Lanham Hills

Roswill

Beacon Heights

Woodlawn

Other:

Required

Recommendations for Potential Members (Optional)

Please provide the contact information for the individual(s) that you would like for us to invite to join the community coalition.

Person 1: Name

Person 1: Email

Person 1: Phone

Person 2: Name

Person 2: Email

Person 2: Phone

Submit

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