Name: PO Box 16304
Address: PO Box 16304, San Diego, CA 92176

Name of Community

Brief Description of your Community including Geographic Area (City, County, Region, etc.):

Full Name of Individual Submitting on Behalf of your Community

Organization

Title

City

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State

Phone

Is texting okay?

What level application are you submitting?

Terms and Conditions: Please check all that apply

I understand that we are requesting a formal assessment be conducted on our community as described above, and that this assessment will be reviewed by C.O.R.E. staff and volunteers.
I understand that the feedback report we receive will be shared by C.O.R.E. only if authorized by the person listed above.
I give C.O.R.E. permission to publicize the name of our community if we receive recognition.
I give C.O.R.E. permission to share our Community Profile on the C.O.R.E. public website.

Please note that the following fees apply:

You will receive an invoice within five days of submission.

Request for Assessment Form