Do you currently rent or own your residence in the City of Las Vegas?
Rent
Own
I do not own or rent a residence in the City of Las Vegas
Do you currently rent or own your residence in San Miguel County, outside of the City of Las Vegas?
Rent
Own
I do not own or rent a residence in San Miguel County, outside of the City of Las Vegas?
How long have you resided in your current home?
0-5
6-11
12-17
18+
How much of your income goes towards your rent/mortgage?
0-30%
31%-50%
51%-70%
71% +
Is your home in need of major repairs? If so, please select which repairs are needed below.
Roof repair/replacement
Electrical
Plumbing
Weatherization (new windows, insulation, sealing, etc.)
How satisfied are you with your current residence's overall physical (inside and outside) condition?
Very Satisfied
Satisfied
Dissatisfied
Very Dissatisfied
Neither Satisfied or Dissatisfied
Are you negatively impacted by the stressed (abandoned/dilapidated)homes in your neighborhood?
Yes
No
Unsure
Would you like to see the stressed homes in your neighborhood renovated/rehabilitated?
Yes
No
Unsure
Would you support a Community Association designed to renovate/rehabilitate stressed homes, including your own (if applicable), if your home is eligible for grant funded repair?
Yes
No
Unsure
Do you support eco-conscious measures within your home and community (i.e.-compost bin for kitchen scraps, energy-efficient gardens, solar panel installation, etc.)?
Yes
No
Unsure
Would you join a Community Association, if as a member, you were issued a membership payout at the end of each profitable year?
Yes
No
Unsure
Would you be interested in volunteering your time and skill(s) to join Zinnia's Place in starting a Community Association designed to renovate/rehabilitate stressed homes in the City of Las Vegas/San Miguel County?
Yes
No
Unsure
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Submit
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