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Interest Form

Milepost 5 is about creating an empowering community for creatives, established or emerging, who are committed to furthering themselves, their work and our community. To do that, weâ€™re looking forÂ those excited by this undertaking, and excited to be a part of it.

First Name: *

Last Name: *

Street Address: *

City: *

State: *

Zipcode: *

Daytime Phone: *

Evening Phone:

Email: *

Website:

Referral:

Creative Pursuit: *

What is your primary creative pursuit? Describe briefly.

Creative Pursuit Comments:

Further comments on your creative pursuit:

Housing Status:

Rent

Own

Do you currently:

Duration: *

How long have you been at your current address? (months)

Housing Intention: *

Rent

Own

At Milepost 5 do you hope to rent or own?

Income: *

Under $10,000

$10-20,000

$20-30,000

$30-40,000

$40-50,000

$50-60,000

$60-70,000

$70-80,000

$80-90,000

$90-100,000

Over $100,000

What is your household income before taxes?

Car: *

Yes

No

Do you own a car?

Transportation: *

5-7 times a week

3-4 times a week

1-2 times a week

1-3 times a month

Never

Other

How often do you bike or use transit to get places?

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Email Address:

Milepost 5 | 900 NE 81st Ave | contact | an ArtPlace Development project | disclaimer