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2. First Name*
3. Last Name*
5. Address1*
7. Address2
9. City*
10. Zip*
12. What is your Council District
    -- Select One --District 1District 2District 3District 4District 5
13. Council District Map
    Council District Map
15. Email Address*
16. Contact Phone Number*
18. We often take photos during the program to help with promotional materials and social media. Do we have your permission to share photos that you may be in during the program?*

    1. YES
    2. NO
20. Why are you interested in CGA and what do you hope to learn?
22. How did you hear about the CGA?
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23. 1. Receive an email copy of this form.
24. Email address

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