Santa Cruz County 6th Cycle Housing Element Community Panel Sign-Up Form Survey

Thank you for your interest in Santa Cruz County's Community Panel. This group will help improve County housing policy and programs. The County will include group recommendations in its upcoming Housing Element update.

If invited to take part, we ask that you attend five (5) weekly meetings between April 13, 2023 and May 11, 2023. The Panel will meet every Thursday evening from 5:30 to 7:00 p.m. during this period. You will receive a $25 gift card after each meeting you attend.

We are looking for individuals who live and/or work in the County’s unincorporated areas. We also want people who have trouble finding or affording housing in the County. The Panel will represent the diversity of the County in its many forms.

To join the Panel, please complete this sign-up form by March 31, 2023 at 12:00 pm. We will respond with more information by April 4, 2023.

For more information about Santa Cruz County's Housing Element update, click here.

1.Please share your:(Required.)

Name

Address

City/Town

Zip Code

Email Address

2.What type of home is your home at the address above?(Required.)

Single-family home, condominium or townhome

Rental apartment or other rental unit, SRO or ADU/granny unit

Emergency shelter or transitional housing

Mobile/manufactured home in a mobile home park

Other (please specify)

3.If you are currently participating in an affordable housing program, please check the type of program:(Required.)

Rental assistance (Housing Choice Voucher/Section 8, Emergency Housing Voucher, TBRA)

Affordable rental housing (subsidized or BMR rental unit)

On a waitlist for Section 8 or affordable rental unit

Affordable homeownership program (Measure J/Measure O/BMR), or First-Time Homebuyer/Downpayment Assistance program

I am not participating in any affordable housing programs

Other affordable housing program (please specify)

4.What is your race or ethnic identification? Select all that apply.(Required.)

Other (please specify)

5.What is your total annual household income before taxes (i.e., gross income)?
Include your gross income plus that of any household members aged 18 or older, except for full-time college students. Income includes wages, cash benefits, pension, social security, investment earnings, self-employment, rental property income, etc.(Required.)

6.Including yourself, how many people live in your household?(Required.)

7.What language do you primarily speak at home?(Required.)

English

Spanish

Other (please specify)

8.What is your age group?(Required.)

Gen Alpha (born after 2010)

Gen Z / iGen / Centennials (born between 1995 and 2010)

Gen Y / Millennials (born between 1977 and 1994)

Gen X (born between 1965 and 1976)

Baby Boomers (born between 1946 and 1964)

Traditionalists/ Silent Generation (born between 1928 and 1945)

Greatest Generation (born before 1928)

10.Do you have a disability?(Required.)

Yes

11.If you live within the city limits of Capitola, Santa Cruz, Scotts Valley or Watsonville, or in a different county (Monterey, San Benito), but work in Santa Cruz County, please provide the name and address of your primary worksite in Santa Cruz County:(Required.)

Employer Name

Address

City/Town

Zip Code

12.Which of the following meeting dates and times are you available to participate?(Required.)

Thursday, April 13, 2023 from 5:30 to 7:00 p.m. - virtual meeting

Thursday, April 20, 2023 from 5:30 to 7:00 p.m. - virtual meeting

Thursday, April 27, 2023 from 5:30 to 7:00 p.m. - in person meeting, location TBD

Thursday, May 4, 2023 from 5:30 to 7:00 p.m. - virtual meeting

Thursday, May 11, 2023 from 5:30 to 7:00 p.m. - in person meeting, location TBD

1 / 1

100%