Action Request Form
Thank you for your interest in creating a plan to make our neighborhood a thriving community! Action request forms must be completely filled out before they are presented to the board to vote on bringing the issue to agenda. Action requests can only be submitted by active members of the R.P.N.A. (no more than 3 requests per month. Please prioritize)
Are you a member of Royal Poinciana Neighborhood Association?
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Yes
No
Click here if you’d like to join Royal Poinciana Neighborhood Association
Name
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First Name
Last Name
Date
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Month
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Day
Year
Date
Project Title
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What would you like to call your Initiative ?
Is there a specific address/block/ intersection to the problem?
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All issues addressed must be within the Royal Poinciana Neighborhood district.
What is your issue of concern that you would like to request neighborhood action upon?
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What is your proposed solution to the problem?
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All projects require volunteers in order to make a difference. Would you be willing to volunteer some of your time for this project?
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Yes
No
What sort of finances would be needed to act on the issue?
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How many additional volunteers would be needed for the issue to be resolved?
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Is the solution sustainable? Or how many volunteer hours/finances per week would it require?
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When is the projected date to launch program?
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When is the projected date to complete program?
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Majority Vote?
Yes
No
Date Voted on
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Month
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Day
Year
Date
Submit
Should be Empty: