Action Taken in your Community

First name

Last name

Email

Phone

Address

Specify the zone, neighborhood, and department you are assisting or wish to assist. ( ex: Village Jasmin, Leogane, Department L'Ouest)

Committee Name

Name of the group or committee responsible to lead the project.

Committee Team Name & Position

Role in the Community

Provide details of your contributions and activities within the community.

File upload

Add up to 10 files.

Upload pictures of the actions you have taken in your community.