Name * First Last

Address * Street Address City Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Americas Armed Forces Europe Armed Forces Pacific State ZIP Code

Email * Enter Email Confirm Email

Phone *

Age Range * 18-30 31-40 41-49 50-70 70+

Race American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Other

Preferred Pronouns * She/Her/Hers He/Him/His They/Their/Theirs Other

City Councilor * Clinton Woods Hunter Williams Valerie Abbott William Parker Darrell O'Quinn Crystal Smitherman Wardine Alexander Steven Hoyt John Hilliard I don't know

I reside in.... * Unsure of which is your district? Copy and paste this link and enter your address to find out https://www.birminghamalcitycouncil.org/residents/which-district-is-yours/ District 1 District 2 District 3 District 4 District 5 District 6 District 7 District 8 District 9 I don't know

Neighborhood *

Do you attend neighborhood meetings? * You do not have to attend neighborhood meetings to participate Yes No

Please list any boards or agencies you have served on [NOTE: You do not need to be part of any board or agency to participate]

Which of the following City events have you attended? * you do not have had to attend city events to participate Community Town Halls

Special Programs (Awaken, A Conversation of Jeff Johnson, Let's Talk, Etc.)

Mayoral Strategic Updates (The First 100, The BIG Picture, State of the Community)

Holiday Events (Holiday Tree Lighting, Halloween Carnival, Easter Egg Hunt)

City Council Events

Other

What areas of government would you like to learn more about during this program? *

Please rank Mayor Woodfin's Strategic Goals for Birmingham in terms of interest to you (Click and drag into place) Safe, Secure and Sustainable Communities

Healthy, Thriving and Diverse Neighborhoods

High-Performing, 21st Century Education and Workforce Development Systems

Innovative and Inclusive Economy Supported, Shared and Served by All

Highly Effective, People-First, Smart Government

Global, Legacy Leadership Partner for Equity and Social Justice

The City reserves the right to select participants based on the evaluation criteria for ACE program applications.