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Coastside Recovery Initiative - Recovery Task Force Application Form

  1. 1. Do you live or work on the Coastside or both? The Coastside is defined as the area from Montara south to the County line and east to Skyline Boulevard. (Please check one)

  2. 2. If you live on the Coastside, in which community do you currently reside? (Please check one)

  3. 3. What gender do you identify as?

  4. 4. Which of the following best describes your race or ethnicity?

  5. 5. Which of the following best describes your age?

  6. 6. What is the highest level of education you completed?

  7. 7. If you live on the Coastside, how long have you been a resident here? (Please check one)

  8. 8. Which of the following best describes your current occupation? (Please check one)

  9. 9. How many people work at your place of employment?

  10. 10. Recovery Task Force meetings will be one hour and held twice monthly during the initial launch phase of the Initiative and then monthly when appropriate. Can you commit to regularly attending these meetings?

  11. 11. Recovery Task Force members will be expected to be champions of the Coastside Recovery Initiative, assist with identifying data sources and people to talk to regarding the economic impacts of COVID-19 and unmet needs, and help formulate short- and long-term recommendations. If selected to participate, would you be able to fulfill these roles?

  12. Thank you for taking the time to complete this application. We will notify you during the week of February 22, 2021 if you have been selected to participate. Your interest in the Coastside Recovery Initiative and serving on the Recovery Task Force is greatly appreciated.

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  14. This field is not part of the form submission.