Membership Application Portland Public Safety Action Coalition (PSAC) General Membership Application Form Name* First Last Email* Enter Email Confirm Email Phone*Affiliation(s) (This field is optional.) Please separate affiliations with a semi-colon.Your neighborhood*--- I do not live in Portland, Oregon ---AlamedaArbor LodgeArdenwald/Johnson CreekArgay TerraceArlington HeightsArnold CreekAshcreekBeaumont-WilshireBoiseBrentwood/DarlingtonBridgetonBridlemileBrooklyn Action CorpsBuckmanCathedral ParkCentennialCollins ViewConcordiaCreston-KenilworthCrestwoodCullyDowntownEast ColumbiaEastmorelandEliotFar SouthwestForest ParkFoster-PowellGlenfairGoosehollowGrant ParkHayden IslandHayhurstHazelwoodHealy HeightsHillsdaleHillsideHollywoodHomesteadHosford-AbernethyHumboldtIrvingtonKentonKernsKingLaurelhurstLentsLinntonLloyd DistrictMadison SouthMaplewoodMarkhamMarshall ParkMill ParkMontavillaMt Scott-ArletaMt TaborMultnomahNorth TaborNorthwestNorthwest HeightsOld TownOverlookParkrose HeightsParkrosePearlPiedmontPleasant ValleyPortsmouthPowellhurst-GilbertReedRichmondRose City ParkRosewayRussellSabinSellwood-MorelandSouth BurlingameSouth PortlandSouth TaborSouthwest HillsSt JohnsSullivan's GulchSumnerSunderlandSunnysideSylvan-HighlandsUniversity ParkVernonWest Portland ParkWilkesWoodland ParkWoodlawnWoodstockWhere in Portland, Oregon do you live?Do you live, work, attend school, own property, own a business, or worship in Portland, Oregon?* Yes No Please describe . . .*Describe how or where you work, attend school, own property, own a business, or worship in Portland, Oregon.How did you learn about Portland PSAC?*What are your primary public safety concerns?*My area of involvement will be to serve on the following committee(s)* Advisory Committee (review and recommend action items to the Board) Communications (media relations, social media development, and community outreach) Government Relations (networking and political candidates and leaders) Research (as needed to support action initiatives) Additional commentsPhoneThis field is for validation purposes and should be left unchanged.