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Union
Corners Planning Studio Application
Please
print out the application and return it
to:
East Isthmus Neighborhoods Planning Council,
1321 E.
Mifflin St. Suite 201,
Madison, WI 53703
by Tuesday,
Nov. 4th.
Please print clearly.
Name
____________________________________________________________
Address
__________________________________________________________
_________________________________________________________________
_________________________________________________________________
Email
____________________________________________________________
Can you read Microsoft Word
attachments? Yes No
How often do you check your
email? ____________________________________
Daytime phone
___________________ Evening phone ____________________
What group(s) or
organization(s) are you a member of that you would be able
to represent in the planning
process?__________________________________________________________
_________________________________________________________________________
If possible,
please provide a name and contact information for another
member of each of the group(s) or organization(s) you would
be representing: ________________________
__________________________________________________________________
(Note: you are
welcome to attend all of the meetings as an individual just
giving your own opinion, but we want to make sure that the
important stakeholders are represented in the
"Studio" group; the above information will help us
do so. A "group" can include an unorganized
geographic area of neighbors, as long as you are willing
& able to talk to them & bring their input to the
meetings).
Would it help
you attend the meetings if we provided childcare? Yes No
If Yes, please
tell us the age(s) of your child(ren):
_______________________________
Other people you would
recommend to be part of the Planning Studio group: _________
_________________________________________________________
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