Raccoon River Neighborhood Association
Member Information Form

Name(s)       E-mail address

Address       Zip Code

Home phone       Cellular / other phone

Are you a registered voter?       How long have you lived in your current home?

In regard to our neighborhood, what are you especially interested in or concerned about?

What kinds of activities, events, and/or resources would you like to see planned by the neighborhood association? (Some ideas include BBQs, kite flying days, gardening swaps, clean-up days, organizing a list of babysitters, holiday parties, etc.)

The neighborhood association needs your help and involvement. How would you like to be involved?

Amount of time you can help?       Most convenient time for you to help?

The association needs help with these areas and more. Please check all that apply to you and your family.
      Leadership
      Community Organizing
      Writing
      Printing and Copy Services
      City Planning Knowledge
      Graphic Design
      Environmental Knowledge
      Nonprofit Organization Knowledge
      CPA / Accounting
      Website Development
      Gardening / Landscape
      Legal Expertise
      Engineering Knowledge
      Law Enforcement
      Event Planning


Block captains distribute flyers to neighbor's doors. Are you willing to be a block captain?
      Yes
      No
      Maybe

Please list the streets or areas you are willing to cover as a block captain - every little bit helps!

Thank you for your interest and participation