Pasadena/Edgebrook: Yes! to the Census Coordination Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for coordinating with Houston in Action!

Together, we will ensure a complete count in Harris County and the City of Houston! Houston in Action plans to support organizations and leaders that live in the 10 regions with the lowest census response rates. With your support, Houston in Action will kick off this phase of the Census Campaign with Pasadena/Edgebrook.

Please fill out this document to the best of your abilities based on new and/or planned activities and networks that you have relationships with in Pasadena/Edgebrook.

Email *

Your name *

Name of your Organization/Business *

If you do not work with an organization and are signing in as an individual write N/A

Phone Number *

Check Yes or No based on the areas in Pasadena/Edgebrook are you and/or your organization are going to focus in? *

Yes

Pasadena

Edgebrook

Are there any other AREAS in Pasadena/Edgebrook that you are prioritizing that are not on the list above? If yes please lest them below. *

If no write in "No."

Pick your top three contact (lists) by clicking Yes or No based on the community leaders/influences you will reach out to. *

Check all that apply

Yes

Principals

Apartment Managers

Church/Mosque/Synagogue/Temple

Health Clinics

Restaurants / Food Trucks

Elected Officials

Civic Clubs

Businesses

Community Centers/Parks

Are there any other Leaders/Influencers in Pasadena/Edgebrook that you will be reaching out to that are not on the list above? If yes please list them below. *

If no write in "No."

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Houston in Action. Report Abuse

Forms