Precinct One Community Affairs & Advocacy Engagement Survey

1. First name *This question is required.

2. Last name *This question is required.

3. What is the name of the neighborhood or community where you live? *This question is required.

5. In your opinion, what would you say is a strength or asset of your neighborhood or neighbors?
In other words, what's the best thing about your neighborhood or what do you like most about it? *This question is required.

6. In your opinion, what is the most challenging issue facing your neighborhood or neighbors?
In other words, what do you want to change about your neighborhood or what needs to get fixed or addressed in your neighborhood for it to improve? *This question is required.

9. What is your phone number? (e.g., 713-123-4567) *This question is required.

9. What is your email? *This question is required. This question requires a valid email address.

Thank you! We are almost done, but we would like to collect a little more information about yourself. Your demographic information will help us ensure we are reaching out to constituents who can represent the diversity and range of people living in Precinct One.

9. What is your zip code? (e.g., 77090) *This question is required.

12. In what year were you born? (e.g., 1965)

We would like to get your contact information to keep you informed about the Precinct and to stay in touch. Please consider providing your phone and/or email below.

14. (Optional) What is your phone number? (e.g., 713-123-4568)

14. (Optional) What is your email? This question requires a valid email address.

14. We are almost done! Is there anything else you would like to say or share about you, your neighborhood, or Precinct One?