City of Beaverton Form

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Voices of Beaverton

  1. If you would like to share your housing story, please fill out the form below.

    * indicates required field

    Basic Information

  2. Do you have a disability?

  3. Income and Housing Costs

    The following is used to determine your Income Bracket. Neither your income nor your household size will be listed.

  4. Rent or Own?*

  5. Your Story

  6. Information in this form may be subject to disclosure under Oregon Public Records Law.
    Personal contact information includes home or personal cellular phone numbers, home addresses, and personal email addresses. Income and housing cost information includes household income, household size, and monthly rent or mortgage.

  7. Let us know if you would like to keep your personal contact information and income and housing cost information confidential. *

  8. Would you like to stay updated on events or developments related to the Voices of Beaverton project? *

  9. Do you want to email us your photo?*

    By submitting a photo I authorize the City of Beaverton to use the image to promote or publicize the Voices of Beaverton project. I understand and agree that the publicity that the City publishes or issues for this project may be distributed on the internet and other media and may otherwise be available to the general public.

  10. Leave This Blank:

  11. This field is not part of the form submission.