AD79 Community Feedback Form

November 8, 2023

As a representative of the 79th district, I want to ensure I adhere to my constituents' needs. Please take a moment to answer the following questions relating to changes you want to see made in the Bronx.

Title

First Name

Middle Initial

Last Name

Suffix

Phone Number

Confirm Email

Address

Address Line 2

Apt Number

City

State

Zip

1. Safety - How can we make our community safer?

2. Education - What's working in our education system, and what can we improve?

3. Health/Wellness - What do we need to become a healthier Bronx?

4. Housing - What are the most pressing housing concerns you have or have heard of recently?

5. Street Repairs - Which streets near you need the most attention and why? (Share location)

6. Other - What other issues should I be aware of?

User Name

Assemblymember

Chantel Jackson

Assembly District 79

AD79 Community Feedback Form