Demographics Data Collection Form

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

Please help us collect data about Nepali population/ distribution in the state of Washington. This will help us plan our community building project better.

This data will help us to decide where should we focus on building our community building. This data will also help us to prove the size of our Nepali community to the state of Washington and request for resource allocation accordingly.

Your data will only be used for the community building project. Nepal Seattle Society will share this data with only community building ad-hoc committee (soon to be an independent 501 c 3) which is leading the Community Building project. If you have any question or concern, please email us at Info@NepalSeattle.org

We really appreciate your help and hope to have your support to bring this massive community building project to fruition.

Full Name *

Number of household (How many family members do you have in your house including you?) *

Which city do you currently live in? *

What is your zip code ? *

What is your field of work? (e.g. Self-employed, tech, etc) *

Email (Optional : We will use it to send you updates about the project)

Phone Number (Optional)

Do you have any additional feedback for us ?

Are you interested in joining our team and volunteer in one of our committee? *

Yes

Clear form

Never submit passwords through Google Forms.

This form was created inside of saurav kakshapati.

Does this form look suspicious? Report

Forms