Arkansas Counts Census 2020 Complete Count Committee and Subcommittee Nomination Form
Thank you for your interest in serving on an Arkansas Counts Complete Count Committee or Subcommittee. Committee members will be notified in April, must agree to meet monthly or as needed as determined by each committee and serve until June 2020.

If you need further assistance or have any questions, contact info@arkansasimpact.org. Be sure to follow us on Facebook at @ARcensus2020 and Twitter @ar_census for news, events and alerts related to the 2020 Census.
First Name *
Last Name *
Email Address *
Address *
City *
Zip *
County *
Type of Sector *
Name of Organization *
Phone Number *
May we text you at this number? *
I am interested in serving on the following Arkansas Counts Complete Count Committee or Subcommittee: *
Please select a second choice. *
Briefly explain your interest in serving on this committee and how your background and experience can help our efforts. *
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