2014 Neighborhood Board Retreat Application Greetings and thank you for your interest in N&BS's Neighborhood Board Retreat.The retreat is open to neighborhood and business associations within the City of Charlotte. Please complete this survey to be considered for participation. Note that priority consideration will be given to first time attendees. Question Title * 1. Name of Neighborhood or Business Organization: Question Title * 2. Describe your neighborhood's location. Please be as detailed as possible by providing bounding streets or a common area address. If you prefer you may email a map to enmitchell@charlottenc.gov Question Title * 3. Has your neighborhood or business association participated in a previous Neighborhood Board Retreat hosted by Neighborhood & Business Services? Yes No Not Sure Question Title * 4. Below you'll be asked to provide your contact information, what other methods does your neighborhood use to communicate? Rarely Sometimes Often I Don't Know N/A Word of Mouth Word of Mouth Rarely Word of Mouth Sometimes Word of Mouth Often Word of Mouth I Don't Know Word of Mouth N/A Website Website Rarely Website Sometimes Website Often Website I Don't Know Website N/A E-Mail E-Mail Rarely E-Mail Sometimes E-Mail Often E-Mail I Don't Know E-Mail N/A Telephone Tree Telephone Tree Rarely Telephone Tree Sometimes Telephone Tree Often Telephone Tree I Don't Know Telephone Tree N/A Facebook Facebook Rarely Facebook Sometimes Facebook Often Facebook I Don't Know Facebook N/A Nextdoor Nextdoor Rarely Nextdoor Sometimes Nextdoor Often Nextdoor I Don't Know Nextdoor N/A Community Newsletter Community Newsletter Rarely Community Newsletter Sometimes Community Newsletter Often Community Newsletter I Don't Know Community Newsletter N/A Text Messaging Text Messaging Rarely Text Messaging Sometimes Text Messaging Often Text Messaging I Don't Know Text Messaging N/A Twitter Twitter Rarely Twitter Sometimes Twitter Often Twitter I Don't Know Twitter N/A Door-to-Door (flyers, door hangers, etc) Door-to-Door (flyers, door hangers, etc) Rarely Door-to-Door (flyers, door hangers, etc) Sometimes Door-to-Door (flyers, door hangers, etc) Often Door-to-Door (flyers, door hangers, etc) I Don't Know Door-to-Door (flyers, door hangers, etc) N/A Signage (temporary signs, community bulletin board, etc) Signage (temporary signs, community bulletin board, etc) Rarely Signage (temporary signs, community bulletin board, etc) Sometimes Signage (temporary signs, community bulletin board, etc) Often Signage (temporary signs, community bulletin board, etc) I Don't Know Signage (temporary signs, community bulletin board, etc) N/A Bilingual Correspondence Bilingual Correspondence Rarely Bilingual Correspondence Sometimes Bilingual Correspondence Often Bilingual Correspondence I Don't Know Bilingual Correspondence N/A If your organization has a website please provide the address/url Question Title * 5. Please provide us with your contact information: First Name: Last Name: House Address Number: Street Name: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Email Address: Phone Number: Question Title * 6. What is your role or title within the organization? Question Title * 7. How many members serve on your board? Question Title * 8. When was the board created or established? Question Title * 9. How often do you meet? Annually Monthly Weekly As Needed Other (please specify) Question Title * 10. Does your board have a mission? If so please provide it below. Question Title * 11. Has your organization applied for grants through the City or other entity's before? If so, please describe below. Question Title * 12. What do you perceive as your organizations biggest challenge? Question Title * 13. What resources would be most beneficial to your organization? Question Title * 14. Are there current community challenges, local regulations or city programs that you'd like to receive more information on? We may not get to this at the retreat but we will follow up with you. Question Title * 15. Please list any recent accomplishments you would like to share. Question Title * 16. Provide contact info for at least 5 and up to 15 participants who will attend the retreat. Participants may be board members, community partners, residents or anyone who will have a direct role in implementing the community's plans. 1. Name Email Role/Position on Board 2. Name Email Role/Position on Board 3.Name Email Role/Position on Board 4.Name Email Role/Position on Board 5. Name Email Role/Position on Board 6. Name Email Role/Position on Board 7. Name Email Role/Position On Board 8.Name Email Role/Position On Board 9. Name Email Role/Position On Board 10.Name Email Role/Position On Board 11. Name Email Role/Position On Board 12. Name Email Role/Position On Board 13. Name Email Role/Position On Board 14. Name Email Role/Position on Board 15. Name Email Role/Position on Board Question Title * 17. How did you learn about the N&BS Neighborhood Board Retreat? Question Title * 18. Would you like to be notified about grants, training opportunities and other pertinent info from Charlotte's Neighborhood & Business Services Department? Your contact info will not be shared. Yes No Done
