WEST ELIZABETH ENHANCED TRAVEL CORRIDOR (ETC) PLAN:
STAKEHOLDER COMMITTEE APPLICATION
Over the course of the next year, the City of Fort Collins will be conducting the West Elizabeth Enhanced Travel
Corridor (ETC) Plan with the help of a Stakeholder Committee (SC). Please see fcgov.com/westelizabeth for more
information about the planning effort.
The SC will meet approximately five times, starting in June. The meetings are tentatively scheduled for
Wednesday evenings and will be 1½ hours in length. The SC will be selected through an open application process
by City of Fort Collins staff. If you are interested in serving on the SC, please complete and return the following
application to Amy Lewin at [email protected] by May 17, 2015.
Name:
Address:
Email:
Phone:
We are seeking a range of backgrounds and interests to represent a cross-section of residents, businesses, and
other stakeholders in the West Elizabeth Corridor. Please answer the following questions to help us ensure that
committee represents a balanced, diverse group.
1. The green shading on the map above shows the general area of the West Elizabeth Corridor. Based on this
map, which of the following apply to you? (select all that apply)
☐ Resident in West Elizabeth Corridor
☐ Property owner in West Elizabeth Corridor
☐ Business owner in West Elizabeth Corridor
☐ Employee in West Elizabeth Corridor
☐ CSU student
2. If you are a resident or business owner, how long have you lived and/or owned a business in the area?
☐ 0 to 5 years
☐ 6 to 10 years
☐ 11 to 20 years
☐ More than 20 years
3. What is your current occupation?
Occupation:
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Employer:
Please complete the back page
WEST ELIZABETH ENHANCED TRAVEL CORRIDOR (ETC) PLAN:
STAKEHOLDER COMMITTEE APPLICATION
4. What is your age?
☐ Under 18 ☐ 18 to 24
☐ 25 to 34 ☐ 35 to 44 ☐ 45 to 54 ☐ 55 to 64 ☐ 65 to 74 ☐ Over 75
5. With what gender do you identify?
☐ Male ☐ Female
☐ Other
6. Which travel mode do you use most often in this corridor? (Please select one)
☐ Bike ☐ Bus
☐ Car ☐ Longboard/skateboard ☐ Walk ☐ Other: __________________________
7. Meetings are tentatively scheduled for Wednesday evenings in June, August, October, January, and April.
For backup scheduling purposes, please identify weekday meeting times that are convenient for you.
Morning
Afternoon
Evening
Monday
Tuesday
Wednesday
Thursday
Friday
8. Briefly tell us why you would like to serve on the Stakeholder Committee for the West Elizabeth Enhanced
Travel Corridor Plan.
9. List any special background, experience, or interests you have that would be helpful to this committee.
10. How did you hear about this committee?
☐ Postcard in the mail
☐ Website
☐ Newspaper article
☐ Other: ______________________________________________________
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☐ West Elizabeth ETC Plan Listening Sessions
☐ Email list