City of Mesa, Arizona

Neighborhood Registration Form

Name of Neighborhood Year(s) neighborhood built Represents approx. number of homes HOA? Yes, it is an HOA No, no there is no 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 Email Please don't send

 

SPOUSE INFORMATION (if applicable) Name Title Preferred Phone Alternate Phone Email Address Zip How would you like to receive the Across the Back Fence newsletterEmail Please don't send

 

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?Yes, we have a block watch No, we don't have a block watch If no, woudl you like to be contacted about forming one?Yes, please contact me about forming a block watch No, please do not contact me about forming a block watch Does your neighborhood/HOA have a newsletter:Yes, we have an HOA newsletter No, we do not have an HOA newsletter If yes, editor/contact name Does your neighborhood/HOA have a Web site?Yes, we have an HOA Web site No, we do not have an HOA Web site If yes, what is the URL? Does your neighborhood/HOA have regular meetings?Yes, we have regular HOA meetings No, we do not have regular HOA 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 newsletterEmail Please don't send

 

ADDITIONAL CONTACT  Name Title Preferred Phone Alternate Phone Email Address Zip How would you like to receive the Across the Back Fence newsletterEmail Please don't send

 

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