Harrietta Village Community Interest Form Let us know how we best can serve you: the Harrietta Community! Community Interest FormHave you attended, been involved in, or benefited from local resources, events, or groups? Yes NoWhich ones? (check all that apply) Quilt Guild Civic Club Firewood Ministry Food & Personal Pantry Garden Club Community Meals Blueberry Festival Religious Services/Events Fire Department Youth Club Other (add in text box below)OtherAre you interested in attending, being involved in, or benefiting from local resources, events, or groups? Yes NoType of Event(s) or Resource(s) (check all that apply) Community Meals (Potlucks) Child & Teen Activities Religious Services/Events Book Club (secular) Study Group (religious) Community Involvement (ie Civic Club) Village Beautification Educational (workshops or classes) Free Food & Personal Item Resources Other (add in text box below)OtherAge Range(s) of Anyone Interested (check all that apply) 12 & under 13-17 18-24 25-34 35-45 45-54 55-64 65+What is your availability or preferred time(s) to attend or be involved in events?Week of the Month Preference (check all that apply) First Week Second Week Third Week Fourth WeekTime of Day Preference (check all that apply) Morning (9-11am) Afternoon (12-5pm) Evening (6-8pm)Day of the Week Preference (check all that apply) Sunday Monday Tuesday Wednesday Thursday Friday SaturdayAre there any past local resources, events, or groups you'd like to bring back? Yes NoWhich ones? (check all that apply) Community Night (HUMC Potluck) Ecumenical Service Street Dances 5K (Turkey Run) Movie Nights Easter Egg Hunt July 4th Picnic and/or Fireworks Youth Club Other (add in text box below)OtherWhat changes would you like to see in the community?Would you like us to contact you about upcoming local resources, events, or groups? Yes NoWould you like to volunteer for local resources, events, or groups? Yes NoWould you like to donate for or to local resources, events, or groups? Monetary Donations Item Donations NoFirst NameLast NamePrefered Method of Contact Call Text EmailPhoneEmailAdd additional comments and/or questions below:Submit Feedback Would you be interested in a monthly community movie screening? Click Here