Intake form

Name *

Email address *

What services are you interested in?

Please select at least one option.

Efficient home construction

Community resource bridging

Local connection fostering

Mentoring programs

Sustainable living solutions

What is your current living situation?

Which community resources do you currently utilize?

Please select at least one option.

Local schools

Healthcare services

Community centers

Employment services

Transportation

What are your goals for your community?

How did you hear about us?

Additional questions or comments

Please confirm that you are not a robot.