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* 1. Are you an organization or a business operating in Ventura County interested in getting involved in Census 2020 outreach? Please fill out the survey below! 

This survey helps us connect you with your regional coordinator(s), the organization leading outreach in your area, and helps us understand where our partners and and do not have capacity. Additionally, if you are a community based organization, submission of this survey makes you potentially eligible to receive funding for your work.

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* 2. Please indicate which of California's Hard-to-Count populations are included in those served by your organization or business (check all that apply):

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* 3. Please indicate your geographic coverage area(s):

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* 4. Please indicate the way(s) that your organization or business would like to participate to inform your client, customers, employees or service population about the importance of the Census 2020 participation (check all that apply):

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* 5. The County of Ventura and the Complete Count Committee will be working to establish Questionnaire Assistance Centers and Questionnaire Action Kiosks throughout the county. These centers will provide a physical location for residents to access technology and get technical support to fill out their census forms. 

Are you interested in hosting a Questionnaire Assistance Center or a Questionnaire Action Kiosk?

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* 6. Collaboration can be enhanced with regular meetings to ensure proper coordination and strategy. How regularly can you commit attendance of at least one staff member to the Census Complete Count Committee Meetings or Census Sub-Committee Meetings? (CCC meetings occur every 2-3 months, and are held at the Ventura County Community Foundation Building in Camarillo.  Sub-Committee meetings are held once per month at various locations throughout the County.)

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