Marin County - Interview Interest Form

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Thank you for your interest in participating in user interviews with Marin County!

Marin County is working to improve the County's website. To help us understand what people expect from the site, we're interviewing several members of the community.

If you're interested in speaking with us, please fill out this short survey. If you're a good match for what we need, we'll follow up with you by email to schedule a 1-hour, remote video interview. Please note we have a very limited number of interview spots and not everyone will be contacted.

Participants who are selected and complete the interview will be offered a $50 e-gift card as a thank you. Your participation is completely voluntary, and we greatly appreciate your time!

For disability accommodations please phone (415) 473-7411 (Voice), CA Relay 711, or e-mail (mailto:CSelmi@MarinCounty.org) and allow at least five business days for a response. The County will do its best to fulfill requests received with less than five business days’ notice. Copies of documents are available in alternative formats, upon request.

Name *

Email address *

Age *

Which of the following best describe your race/ethnicity? (Select all that apply) *

American Indian or Alaska Native

Asian or Asian American

Black or African American

Latino/a/x or Indigenous

Native Hawaiian or Pacific Islander

White or European

Multi-racial or multi-ethnic (2+ races/ethnicities)

Prefer not to state

Prefer to self-describe:

Other:

Required

How did you hear about this interest form? *

Zip Code *

Do you currently live in Marin? How long have you lived here? *

If you work, what is your job or industry? Please note if you own a business in Marin. *

Which of the following ranges best describes your income before taxes? *

Less than $20,000

$20,001 to $34,999

$35,000 to $49,999

$50,000 to $74,999

$75,000 to $99,999

Over $100,000

Prefer not to state

Do you identify as a person with a disability? *

Yes

Prefer not to state

Other:

Do you have school-aged children in your household? *

Yes

Do you currently own or rent a property in Marin County? *

Own

Rent

Other:

Required

Do you speak any languages besides English at home? If yes, please name which language(s). *

How often would you say you visit the Marin County website? *

Never

Very rarely (1-2 times in the past year)

Occasionally (1-2 times a month)

Very regularly (1-2 times a week)

Other:

If you have visited the Marin County website, please explain why you visited and what you were trying to use the website for.

We are able to conduct the interview in English, Spanish, or Vietnamese. If selected, in what language would you prefer to do the interview? *

English

Spanish

Vietnamese

Other:

This is a video interview that will require a data or internet connection. If selected for the interview, what device would you be doing the interview on? *

Cellphone

Computer (laptop or desktop)

Tablet

Other:

Which, if any, assistive technologies will you be using for the interview?

Screen reader

Voice recognition

Screen magnification

Captions

Keyboard only

None

Other:

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