Sparrows Point Action >> Sign Up Now Sign Up Now *Title : Select Title Mr Mrs Ms Prof. Dr. Select Title *First Name : First Name required. Enter at least 2 characters You can't enter more than 60 characters Only characters. *Last Name : Last Name required. Enter at least 2 characters You can't enter more than 60 characters Only characters. *Address 1 : Address 1 required. Enter at least 2 characters You can't enter more than 100 characters Invalid Format. Address 2 : Address 2 required. You can't enter more than 100 characters Invalid Format. *City : City required. Enter at least 2 characters You can't enter more than 60 characters Only characters. *State : Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming Select State. *Zip Code : Zip Code required. Invalid Format *Email Address : Email Address required. Invalid format. Work Phone : Work Phone required. Only 10 digits Only 10 digits Invalid Format (Pattern: 000-000-0000) Home Phone : Home Phone required. Only 10 digits Invalid Format. (Pattern: 000-000-0000) Please state the best time to contact you : Hours 1:00 2:00 3:00 4:00 5:00 6:00 7:00 8:00 9:00 10:00 11:00 12:00 Select State. Select AM PM Select Time. Please state the best way to contact you :  Phone  Email Please answer the following brief questions, so that we can help you better . Are you a current resident of the Sparrows Point peninsula area, or have you lived near there in the past? Current   Past What is the approximate length of time you have lived at your current address? (If you are a past resident, state the length of time you resided at your former address.)  Years Time required. Only 3 digits Invalid format.  Months Time required. Only 2 digits You can't enter more than 11 months Invalid format. Have you noticed bad odors in the air, or pollution in the water or land on or near your residence?  Yes  No Have you had "kish" (a shiny, metallic grit) falling onto your property?  Yes  No Have you, or members of your family, experienced any of the following: Burning eyes Gagging, or difficulty breathing Nausea Dizziness Asthma Increased sinus conditions Increased allergic reactions Have you, or members of your family, developed any of the following symptoms after exposure to water in your area: Skin lesions Leg sores Ear aches Eye infections Are there activities, such as daily routines or recreation, you would like to take part in but do not because of the pollution in the air, land, or water in your area? What activities are these?     Chrs. Activities required. You can't enter more than 500 characters Are there any other ways you are not able to use or enjoy your property due to the business activities of the industries on the Sparrows Point peninsula?     Chrs. A value is required. You can't enter more than 500 characters   In submitting this form, I acknowledge that I have not yet created an attorney-client relationship with the legal team of Sparrows Point Action, and whether or not such a relationship will be formed will be determined by later contact.