Urban Fellow Application

Applications are accepted throughout the year on a rolling basis.

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?
Which session are you interested in applying to? *
We run four 6-week sessions per year - please choose the preferred session(s) you want to apply for.
Which group are you available to participate in? *
Sessions run two days a week. Please choose the preferred days that you would like to attend. If you have no preference and can attend either the Mon/Wed group or the Tues/Thu group, choose both.
Example: Spanish club on Tuesdays from 3 pm to 4 pm.
How familiar are you with Groundwork Bridgeport? *
How concerned are you about the physical environment in Bridgeport? *
Provide an example of a project related to improving Bridgeport's physical environment that you would like to work on? *