Neighborhood Watch Survey Form

If you have any questions please contact Andrea Zielinski, Community Outreach Coordinator, at (541) 440-4486.

Contact Name:
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Home Address:
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City:
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Zip:
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Contact Phone:
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Contact Email:
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  • Do you currently have a Neighborhood Watch in your area?
  • If yes, are you involved?
  • Do you meet regularly?
  • Approximate number of residences involved:
  • If not, would you be willing to be part of the team that starts a Neighborhood Watch program in your community?
  • If your neighborhood were to start a Neighborhood Watch, in what capacity do you see yourself being involved?
  • Would you be interested in attending a Neighborhood Watch information meeting?
  • Would you like assistance arranging presentations for your group?
  • What are the greatest concerns within your neighborhood that you think Neighborhood Watch could address?
  • Would you like to be contacted to discuss your concerns?
  • Comments:

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