How did you hear about this meeting? ________________________________________

What part of the city/county do you reside in? _________________________________

Have you visited the Southwest Museum? Yes No

If yes, when was your last visit? __________________________________________

Note: The above section is voluntary and is at your discretion to complete. This data is collected for the purposes of analysis.

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In order to insure everyone’s ideas are being considered; please be sure to complete the following questions. You may use the back of this form if you need additional Space.

1. In what ways do you feel that the Southwest Museum has served your community?

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2. What are your ideas for future use of this community site?

Please submit the completed form to the City of Los AngelesHuman Relations Commission via FAX at 213-978-1668 or via e-mail at GaryDeLaRosa@lacity.org by July 5, 2006. Tou may also mail the form to 200 N. Spring Street, Room #1625, Los Angeles, CA 90012.