City of Philadelphia | Community Engagement Call of Interest

Contact Information

Organization Name*

Organization Website

Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Organization Information

What kind of organization are you?*

For-profit organization or sole proprietor
Non-profit

Is your business either registered with the City of Philadelphia's Office of Economic Opportunity OR Rebuild’s Emerging Vendor Program? If so, what type of business are you enrolled as? Select all that apply.*

Disabled-owned Business
Minority-owned Business
Women-owned Business
None or N/A

OEO registration number*

If you are not certified, but are a minority-, women-, or disabled- owned business, are you interested in becoming certified?*

Yes
No
Not applicable

Experience

Describe your organization's work and experience with community engagement. What engagement efforts have you tried? What communities have you worked with? (1,500 character limit)*

What type of engagement activities do you have experience in? Select all that apply.*

Other experience

Do you have experience or expertise engaging with specific populations? Select all that apply.

Youth
Seniors
Residents with Disabilities
Residents with Limited English Language Proficiency
Other

Other experience

Where do you have experience working?

Do you have experience working in specific neighborhoods?

Where are you interested in working?

Are you interested in working on Rebuild projects in specific neighborhoods? Select all that apply.

Additional Information

Please attach any relevant information about your past work.

Allowed file types: doc, docx, ppt, pdf, jpg, png

Drop files here or

Please provide links to any websites or online materials that provide relevant information or examples of your past work. (Optional)

Please confirm that you approve sharing the information you have provided with Project Users and the City of Philadelphia.*

I approve sharing my information with Rebuild, its partners and the City of Philadelphia.

City of Philadelphia Community Engagement Call of Interest