Community Assessment Survey

The city made a public promise with Angelenos, through Measure M (Cannabis Taxation), to remedy the negative impacts with social justice related to the commercialization of cannabis. Since 2018, the city has collected over $330 million in tax revenues—we must hold the city accountable to their social contract of addressing the needs of OUR communities most negatively impacted by the war on drugs.

Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Zip Code*

Email*

example@example.com

Social Media Accounts

From 1-5, how do you rate your knowledge of cannabis. (5 Most Knowledgable)

Are you interested in learning about the wellness benefits of cannabis?

YesNo

The City of Los Angeles has received over $330M in cannabis revenue, would you support a Neighborhood Health Fund to support community programs and youth prevention?

YesNo

We would like to know what’s most important to the residents in our neighborhood! This will help us to build a Community-driven Benefits Plan that will help support and aid in the restoration of our community’s loving and prosperous nature.

Using numbers 1-11, please rank the following in order of importance to you.*

Rows	Numerical Rank
Affordable Housing
Arts and Youth Programs
Cannabis Workforce Development/Job Training
Community Beautification
Education
Elder Care
Families' on the Outside Support Systems
Health/Mental Health Care
Personal & Community Safety
Political/Economic Empowerment
Reentry Programs

Using the above list, please let us know what three (3) categories you are willing to participate in and support. *

Do you participate in a Neighborhood Council, Block Club, and/or Community Organization?*

YesNo

If yes, please provide name and/or council district.

Fortification of Life in our community is our primary goal, therefore, we would like to lend support to those doing impactful work in the community. Please provide the contact information for a person(s) and/or organization(s) you would like to nominate.*

We would like to create an Endowment Fund to encourage and uphold the artistic development of underprivileged youth by supporting Local Arts programs. Please let us know of an art program you would like to nominate.*

Comments and/or Questions:

ECWA and Gorilla Rx have a common goal and through humanitarian efforts strive to uplift our community, we appreciate you taking the time to provide your valued input. For more information please visit www.LifeDevelopmentGroup.org or www.ECWANDC.org.

Thank You!