Census Intake Request Form
Note: Submission of this form does not guarantee participation by NYC Census 2020 staff.  NYC Census 2020 will be in touch if we are able to send staff to your submitted event.
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Email *
Event Date *
MM
/
DD
Event Sponsor / Host *
Event Type (Food Bank, PPE Distribution, Green Market, etc.)
Coordination Contact Name *
Coordination Contact Phone Number *
Coordination Contact Email *
Name of Contact for On-Site, Day-of Communication *
Cell Number of Contact for On-Site, Day-of Communication *
Email of Contact for On-Site, Day-of Communication *
Event Address *
Neighborhood (NOCC)
Is this a recurring event?
What time does the public begin to LINE UP for the event? (If applicable).
Time
:
What time does food distribution or PPE distribution BEGIN?
Time
:
What time should Census Staff plan to arrive? Note: For food distribution events we recommend an arrival time at least one hour in advance of distribution so we can canvas the line for census intake.
Time
:
What time does the event end?/What time should the Census team plan to depart?
Time
:
How many people do you expect to line up to receive food, PPE, or other services? (If applicable.)
What are the most common languages that people who will attend your event speak? (Select all that apply.) *
Required
How many Volunteers can Event Organizers provide? What languages do they speak?
Is this event affiliated with an Elected Official or Community Based Organization? If yes, who?
Is this event being advised to press?
Can Event Organizers provide any of the following? (Please select all that apply)
Please add anything that we should know that was not collected in the previous questions.
Are you an employee of NYC Census 2020? *
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