Southwest: Yes! to the Census Coordination Form
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 Southwest.

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 Southwest.
Email address *
Your name *
Your answer
Name of your Organization/Business *
If you do not work with an organization and are signing in as an individual write N/A
Your answer
Phone Number *
Your answer
Check Yes or No based on the areas in Southwest are you and/or your organization are going to focus in? *
Yes
No
Gulfton
Braeburn
Westwood
Sharpstown
Alief
Are there any other AREAS in Southwest that you are prioritizing that are not on the list above? If yes please lest them below. *
If no write in "No."
Your answer
Check Yes or No based on the tactics you can led/support in increasing the census response rate in (Southwest). *
Check all that apply
Yes
No
Phone Banking
Text Messaging
Flyering
Yard Signs
Helping people to fill out the 2020 census form via phone, text, or video stream
Online events (webinars, FB events, panels)
Social Media (graphics, posts, challenges)
Digital Advertising
Are there any other TACTICS in Southwest that you are prioritizing that are not on the list above? If yes please list them below. *
If no write in "No."
Your answer
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
No
Principals
Apartment Managers
Church/Mosque/Synagogue/Temple
Health Clinics
Restaurants / Food Trucks
Gas stations
Chambers of Commerce
Management District
Metro
Elected Officials
Super Neighborhoods
Civic Clubs
Other non profits
Businesses
Delivery Services
Ethnic Radio Stations
Flea Markets
Parks
Community Centers
Are there any other Leaders/Influencers in Southwest 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."
Your answer
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