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Community Action CCC Nomination Form
The Community Action Partnership is launching a Census Complete Count Committee (CCC), called the Partnership CCC. CCCs are organized in communities across the county to ensure a complete count for 2020's Census.

An accurate count is crucial for our Community Action Agencies to receive adequate funding -- around $2,000 per person, per year, for ten years! - among many other important uses for the data. We are inviting every agency to nominate one person on staff (we'd prefer you not self nominate, but trust you to know your own agency!) to serve as your agency’s key contact on Census news, outreach, and information, to help us ensure a coordinated national response.

To nominate someone for your CAA, please fill out the information below:

Email address *
Agency *
Your answer
Street Address (for potential materials) *
Your answer
City *
Your answer
State Abbreviation *
Your answer
Zipcode *
Your answer
County/Counties Served *
Your answer
Your Name and Title *
Your answer
Your Nominee's Name *
Your answer
Your Nominee's Email Address *
Your answer
In just a couple of sentences, why do you think this person is a good nominee and deserves this recognition?
Your answer
Comments or Questions
Your answer
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