date ______________

Complete any or all sections. Return to CV Heritage, c/o 5001 Carolyn Way, Glendale CA 91214

Contact information. Required if you'd like to receive meeting announcements and status updates.

Name _____________________________________________________  Phone ________________________

Address___________________________________________________   email _________________________

City, State, Zip______________________________________________

Your concerns? Check all that apply.

____ Preserving open space

____ Verdugo Hills Golf Course                          ____ Canyon Hills

____ the property at the top of Rosemont        ____ Access to Trail Heads

____ other:___________________________________________________________________________________

____ Concern about mansionization                                ____ Loss of single-family homes to multiple-unit projects

____ Recognizing historically significant buildings      ____ Researching my home or building's history

____ Developing a Crescenta Valley Museum              ____ Saving heritage trees

____ Other: _________________________________________________________________________________________



How can you help? Check all that apply

____ Grant writing experience

____ Website creation and maintenance

____ Surveying historic properties

____ Donating historical photographs or other material

____ Providing information on historic properties

____ I'm a realtor interested in historic properties; contact my office ____________________________________________

____ I'm interested in purchasing historic property

____ I'm a member of a home owners association; contact ____________________________________________________

____ Other: _________________________________________________________________________________________