Please print out the form below,  fill it out, sign it,  and mail it back to us at:
Hollywood United Neighborhood Council,  P.O. Box 3272,  Los Angeles, CA 90078  

You may also copy and paste the below Stakeholder Registration form into an email and fill it out there.  Your email will be your electronic signature.  Then send it to us at huncoffice@gmail.com  .

Hollywood United Neighborhood Council
Stakeholder Registration Form


I, _______________________________________,

do hereby announce and declare that I am a stakeholder, 18 years of age or older, located within the boundaries of Hollywood United Neighborhood Council, based on my affiliation as a:
__________Resident

__________Business Owner or Employee

__________Property Owner

 _________Community-Based Organization Member


Name of Organization or Business


A stakeholder is any person who lives, works, owns property, or actively participates in a community organization based within the boundaries of the Neighborhood Council.


MAILING ADDRESS
PRINT INFORMATION CLEARLY.

Name

Address

City,
Zip
Email (needed if you want to get updates from HUNC)

Daytime #
Fax#
Evening #
Alternate #

IF NOT A RESIDENT PLEASE INCLUDE YOUR STAKEHOLDER ADDRESS IF NON-RESIDENT STAKEHOLDER
_________________________________________________________
(EXAMPLE Business, Organization or Property Address


I hereby declare under penalty of perjury, that the above statements are true and correct.


Signature: ___________________________Date: ___________________________


I am interested in working on the following:
Business and Government:
Business Development, Planning, Support Resources,
Government Relations: BID, City of LA, Federal, State, County, DONE
Cultural Affairs:
Entertainment, Cultural Resources and Public Events
Neighborhood and Environment:
Neighborhood Projects, Watch Groups, Homeowner and Renter Groups,
Environment, Beautification, Preservation, HPOZ, Clean-Up and Aesthetics
Outreach and Diversity:
Membership, Translation Services
Safety and Transportation:
Police, Fire, Disaster Preparedness, Neighborhood Watch and Safety,
Transportation: Traffic, Public Transportation Services , Parking, Infrastructure
Social Services:
Senior Services, Homeless Issues, Workplace Issues, Health Care, Housing
Communications:
Newsletter, Web Site, Media, Public Communication, Voicemail
Youth:
Education, Youth Development, Recreational Resources and Parks


Hollywood United Neighborhood Council
 P.O.Box 3272, L.A. CA 90078
Phone 323-957-3784
Email: HUNCoffice@gmail.com
Website: www.HollywoodUnitedNC.org


1. How did you hear about HUNC?
􀂈 Election Flyer or Poster
􀂈 Neighborhood Council website / e-mail updates
􀂈 Newspaper
􀂈 Neighbor / word of mouth
􀂈 Other (please specify)___________________________
2. What topics do you believe are the most important to Hollywood? (For
example, safety, after-school programs, beautification, land use, parking,
etc)
____________________________________________________
____________________________________________________
____________________________________________________

3. Have you participated in the neighborhood council other than voting at
the election? (Please check all that apply)
􀂈 Attended Board or Committee Meeting
􀂈 Filled out budget questionnaire
􀂈 Actively Participated in Committee Meeting

4. What would encourage you to participate more actively with your
Neighborhood Council?
____________________________________________________
____________________________________________________
____________________________________________________

5. Do you watch City of LA City View 35?
􀂈 Yes 􀂈 No

Hollywood United Neighborhood Council Survey