Landings Neighborhood Watch

The Landings Neighborhood Watch Profile Questionnaire

The reason, THE ONLY REASON, for attempting to collect this information is to facilitate communication between like minded residents interested in the welfare of The Landings Neighborhood. This information will be used by the Neighborhood Watch Organizers to create the Neighborhood Map, Telephone Tree and/or Email List with your permission.

NAME

PERMISSIONS
YES	NO	PERSONAL DATA USAGE
		OK to List Name & Phone No. on Telephone Tree (used to rapidly spread news about criminal activity and EMERGENCIES)
		OK to send me Email Emergency Alerts (can be used to supplement the Telephone Tree)
		OK to send me Email Notices, Cautionary Info, and FYI’s (used to inform and give updates about non-urgent issues of importance)
		OK to list my Name, Address, Phone No. and Email on Block/Zone Map (a valuable neighborhood resource w/ Limited Distribution)
		Ignore the options above. I am ONLY providing this Personal Information for the purpose of being notified in the most Extreme Circumstances (Fire, Flood, Invasion by Mutant Zombie Bikers, etc.)

First name:

Last name:

ADDRESS

Number:

Street name:

PHONE

Phone No. 1:

Phone No. 2:

Email Address:

JOIN US...
By joining The Landings Neighborhood Watch you are just indicating your commitment to participate in the spirit of our program: To be observant and to report any suspicious activity to the Coeur d’Alene Police Department directly or through Neighborhood Watch Zone/Block Captains. There is no time commitment -- you “watch” during your normal day-to-day activities. To Join...simply submit this questionnaire.

If, after viewing our website and thinking a bit about it, you have some questions or you feel like you would like to become more involved, well, give us a call at 772-0870, send an email to LandingsWatch@mainthing.com, or check this box prior to submitting this form:

The following information is entirely optional, but could be helpful in case of an Extreme Emergency and will be held in strictest confidence

Work Phone and/or Email:

Special Medical Problems and Instructions:

Special Skills (CPR, First Aid, Amateur Radio, Electrical, Plumbing, Fire Fighting, LEO, Military, etc.):

All done?

This is The Landings at Waterford Neighborhood Watch website and is intended solely for the use of Homeowners Association Members and Residents
Copyright 2011 | Contact: John Rank 208-772-0870 | email: LandingsWatch@mainthing.com