If your organization is interested in serving as a Census Partner, please complete the following information.
First Name
*
Last Name
*
Organization
*
Type of Organization: (Please select one)
*
Advocacy
Business
Chamber of Commerce
Community
Faith-based
Local Government
Neighborhood Association
Non-profit
Healthcare
Student Organization
Tenant Association
University/College Institution
Other
Email
*
Phone
*
Why are you interested in becoming a Census Partner?
*
Please tell us which languages are spoken in the populations your organization serves.
*
English
Arabic
Chinese
French
Japanese
Somali
Spanish
Swahili
Vietnamese
Other
Are you willing to share census-related materials and social media posts with your constituents?
Yes
No
Is your organization able to mobilize volunteers to help with census outreach activities and events?
Yes
No
Is your organization able to provide assistance to residents needing help participating in the census? One example would be providing a laptop or computer tablet at tables where residents can complete census responses online.
Yes
No
If the answer to the last question is yes, please explain.
Social Media Handles
Facebook
Twitter
Instagram
Thank you for your interest in becoming a Census Partner. A member of the MARC staff or our regional complete count committee will contact you regarding your organization's interest in becoming a partner. Please allow 7-14 days for us to get back in touch with you.
Please note that your form is not complete until you hit the submit button.
