You

Name(Required)

First Name

Last Name

Email Address(Required)

Phone(Required)

Job Title(Required)

Your organization

Name of Organization/Business(Required)

Principal Place of Business(Required)

Street Address

Address Line 2

City

Province

Postal Code

Type of Business (Other)(Required)

Please list the communities in British Columbia that you currently operate in(Required)

Why is your group interested in joining the Save Our streets coalition?

Choose any, or all, as applicable

I am a business owner/operator concerned about the safety of my employees and protecting my property.
I am with an organization representing local residents or businesses concerned about their safety and security.
A citizen concerned about my own safety, and the safety of my family and friends on local streets.
I believe all levels of government can and must work together to resolve the ongoing spread of crime and violence in my community.
I am concerned about the costs to all of us resulting from theft, vandalism, and the need for extra security.
Other reason

Other reason for joining(Required)

Would your organization be willing to make a financial contribution to SOS(Required)

YesMaybe (need more information)No

Anything else you would like tell us about your organization?

Consent(Required)

Save our Streets coalition (SOS) has the right to refuse or revoke membership.