Use this form to help us track our Census outreach across Long Island. Together we can get the word out about everything the Census impacts and ensure a Complete Count in 2020!

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* 1. Please tell us about yourself.

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* 2. What Census outreach activity did you complete?

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* 3. What is the scope of this Census outreach?

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* 4. Is there a plan for follow up or next steps? If yes, please describe.

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* 5. If you need resources or materials to help foster future outreach, please describe below:

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* 6. Are there any upcoming events that you would like to register for Census outreach?

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* 7. Please include any additional questions or comments here.

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