Fridley Neighborhood Ambassador Application

Fridley Neighborhood Ambassador Application

Submit this form to request to become a Fridley Neighborhood Ambassador for your neighborhood.
Please note: If you are unable to fill out this form, please email web-info@fridleymn.gov and the City of Fridley will provide assistance.

Neighborhood Ambassador Data Practices Notice
The City of Fridley collects the information on this form under the authority of Minnesota Statutes Chapter 13, the Minnesota Government Data Practices Act (MGDPA).

The personal contact information you provide, including your name, address, phone number and email, is collected for the purpose of enrolling you in the Neighborhood Ambassador Program. This data is classified as private data on individuals pursuant to Minnesota Statutes § 13.37 and 13.548. It will only be accessible to City staff whose work requires it to administer the program and will not be shared with the public.

Certain information related to your participation, such as the area of the City you serve as an ambassador, may be classified as public data and subject to release upon request under the MGDPA.

You are not legally required to provide this information, but the City cannot process your application or enroll you in the program without it. Questions about the City's data practices may be directed to CityClerk@FridleyMN.gov.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Tell us a little bit about why you'd like to be a Fridley Neighborhood Ambassador.

Fridley Neighborhood Ambassador Application

Neighborhood Ambassador Data Practices Notice

Questions?