Survey & Form Center

2. 
4. STRIVIN' TESTIMONALS
   COMBAT is conducting this survey, so that we can hear from you, individuals directly involved in our Striving Together to Reduce Violence In Neighborhoods (STRIVIN’) initiative. We are collecting your testimonials to help raise awareness about STRIVIN’ through our website and social media channels—and to let your words "speak" for the initiative as we seek to encourage others to strive with us to make every neighborhood a safe place to call home.
   
   Please take just a few minutes to fill out this survey.
   
   Thank you.
   
   COMBAT Director Vince Ortega
6. Important
   To submit this form you do not have to sign or create a Form Center account above. However, you will have to complete the form in its entirety without the option to save your progress unless you do create an account.
8. Your First Name*
9. Your Last Name*
11. Your Organization*
12. Your Job Title*
14. e-mail*
16. Your STRIVIN' Neighborhood*

    Check each STRIVIN' Neighborhood in which you or your organization participate.

    1. Northeast Kansas City
    2. South Kansas City (Ruskin)
    3. Independence
    4. Raytown
18. In A Sentence Or Two
    Or however many you'd like, please answer these three questions?
20. How effective has STRIVIN' been in reducing violence in the neighborhood? What makes it effective?
22. How does STRIVIN’ compare to past efforts to reduce violence? What makes it unique, more or less effective, etc.?
24. What can STRIVIN' do better to help reduce violence?
26. Your Digital Signature*
27. Date*
    Date
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

* indicates a required field