NIA Community survey

Your First & Last Name

If chosen, only your first name will be included in our marketing materials.

Your Email

We will not share your email with anyone.

Your Age

18-24

25-34

35-44

45-54

55-64

65+

What neighborhood do you live in and why is your neighborhood/community special to you?

Have you ever been enrolled in NIA after school or used any of our community services? If yes, please explain how NIA has impacted you and/or your community.

Have you ever been employed by NIA? If yes, please explain how working at NIA has impacted you and/or your community.

What does the word “community” mean to you?

OPTIONAL: Is there anything else you’d like to share with us?

OPTIONAL: Upload Photos (Ex: You & your child, neighborhood photo)

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Please confirm that you give NIA consent to use your responses and/or submitted photo(s) for future publications.

Yes, I give consent for NIA to use my responses and/or photo(s) submitted.

NIA Community survey

NIA Community Services Network · 6614 11th Avenue, Brooklyn, NY 11219

Michael A. Bové, President · Mary Anne Cino, CEO

Phone: 718.236.5266 · Fax: 718.236.0971 · info@niabklyn.org

TERMS & CONDITIONS PRIVACY POLICY

NIA is a 501(c)(3) not-for-profit organization. Contributions are tax deductible to the full extent of the law.

Copyright © 2022 NIA Community Services Network, Inc. All Rights Reserved.