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On a scale of 1 through 10, how would you rate the Safety of your community?
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Choice One
1
2
3
4
5
6
7
8
9
10
10 being the highest-very safe and 1 being the lowest-not safe at all.
Describe why you selected that rating?
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Name
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Email
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What is your zip code?
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Describe the types of things your community needs?
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Are there sidewalks in your community?
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Choice Yes/No
Yes
No
Do you feel safe in your community?
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Choice Yes/No
Yes
No
Describe what would make you feel safer?
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What has caused you to feel safe or unsafe in your community?
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Do you believe it is everyone's responsibility to be responsible?
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Choice Yes/No
Yes
No
How can we work together to get each other home safe?
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Upload Video or pictures of any examples to help support your responses
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