Neighborhood Registration Form

Name of Neighborhood


Year(s) neighborhood built
Represents approx. number of homes



HOA?


 

PRIMARY CONTACT (must physically reside in neighborhood)
Name


Title


Preferred Phone


Alternate Phone


Email
Address


Zip


How would you like to receive the Across the Back Fence newsletter





 

SPOUSE INFORMATION (if applicable)
Name


Title


Preferred Phone


Alternate Phone


Email
Address


Zip


How would you like to receive the Across the Back Fence newsletter




 

ORGANIZATION BOUNDARIES Identify by streets, including which side fo the street included in boundaries (i.e. south side of east Reseda St.) Please send us a map if you have irregular boundaries.
North


East


Major neighborhood features (schools, churches, parks, etc.)
South


West


Why were these boundaries chosen for your neighborhood?

 

NEIGHBORHOOD ISSUES - What are the most important issues/concerns facing your neighbhorhood?

 

ADDITIONAL INFORMATION
Do you have block watch(es) in your neighborhood?

If no, woudl you like to be contacted about forming one?

Does your neighborhood/HOA have a newsletter:

If yes, editor/contact name
Does your neighborhood/HOA have a Web site?

If yes, what is the URL?


Does your neighborhood/HOA have regular meetings?

If yes, what is your regular meeting schedule (time, day & location)


How did you hear about the Mesa Neighborhood Registration Program?

 

HOA CONTACT   If HOA, please list property manager/management company information here.
Manager Name


Title


Company Name


Preferred Phone


Alternate Phone



Email


Address

Zip


How would you like to receive the Across the Back Fence newsletter




 

ADDITIONAL CONTACT 
Name


Title


Preferred Phone


Alternate Phone


Email


Address

Zip


How would you like to receive the Across the Back Fence newsletter