Urban Fellow Application

Applications are accepted on a rolling basis.

Name *
Name
Home Address *
Home Address
Home Phone *
Home Phone
If you don't have one, put zeros in.
Cell Phone *
Cell Phone
If you don't have one, put zeros in.
How did you find out about this application? A teacher, a friend, guidance counselor, newspaper, Facebook, email list, other?
Example: Spanish club on Tuesdays from 3 pm to 4 pm.
How familiar are you with Groundwork Bridgeport? *
How concerned are you about the environment in Bridgeport? *
Provide an example of a project related to improving Bridgeport's physical environment that you would like to work on? *