Form Center

2. The Community Services Department strives to provide high-quality and engaging programs that enrich the lives of the Malibu community. Please complete the Community Program Interest Form to submit suggestions to assist the Department in offering programs that reflect the community's needs.
4. 1. Have you previously participated in a City of Malibu Community Services Department program?

   1. Yes, within the past six months
   2. Yes, within the past year
   3. Yes, within the past five years
   4. No
6. 2. What zip code do you live in?

   1. 90263
   2. 90264
   3. 90265
   4. Other
8. 3. How did you hear about City of Malibu Community Services Department programs? Select all that apply.

   1. City of Malibu Quarterly Guide
   2. City of Malibu Staff
   3. City of Malibu Community Event
   4. Friend/Family
   5. Newspaper
   6. Program Flyer at a City Facility
   7. School Distribution
   8. Social Media/Website
10. 4. Which program location do you prefer? Select all that apply.

    1. Malibu Bluffs Park
    2. Malibu City Hall
    3. Malibu Elementary School
    4. Malibu Equestrian Park
    5. Malibu Middle/High School
    6. Malibu Skate Park
    7. Malibu Senior Center
    8. Webster Elementary School
12. 5. What type of programs would you like the City of Malibu Community Services Department to offer? Select all that apply.

    1. Arts (Literary, Performing, Visual)
    2. Aquatics
    3. Before School Classes
    4. Community Events
    5. Creative (Floral Design, Photography, Pottery, etc.)
    6. Culinary
    7. Day Camps
    8. Dog/Animals
    9. Environmental Education
    10. Equestrian
    11. Film and Theater
    12. Fitness
    13. Gymnastics
    14. Language
    15. Outdoor Skills
    16. Poetry
    17. Recreation Therapy
    18. Science
    19. Skateboarding
    20. Sports Leagues
    21. Surfing
    22. Technology/Software
    23. Vocational/Professional Certificates
    24. Wellness
    25. Workshops (Cooking, Creative, Life Skills)
14. 6. Which age range will participate in the suggested programs? Select all that apply.

    1. 5 and under
    2. 6 - 12 years old
    3. 12 - 17 years old
    4. 18 - 34 years old
    5. 35 - 54 years old
    6. 55+
16. 7. Do you prefer weekday or weekend programs?
    -- Select One --WeekdayWeekendNo preference
18. 8. Which time of day do you prefer?

    1. Morning (8 - 10 AM)
    2. Mid-Morning (10 AM - 12 PM)
    3. Lunchtime /Afternoon (12 - 3 PM)
    4. Afterschool (3 - 5 PM)
    5. Evening (5 - 8 PM)
20. 9. Additional comments, questions or suggestions.
22. 10. Would you like to be contacted regarding the feedback you have provided?
    -- Select One --YesNo
24. If yes, please fill out the information below:
26. First Name
27. Last Name
29. Email Address
30. Phone Number
32. If you are interested, or know someone who might be interested in instructing a program, please visit MalibuCity.org/ContractInstructor and submit the Intent to Instruct Form.
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field