Carmen De La Rosa for City Council Community Survey
This survey is for residents and businesses of the 10th City Council District.

As Carmen begins her transition to City Hall in January 2022, she wants to hear from you!

The needs and vision of the community are essential as she further develops her priorities in the next City Council.

***We collect certain demographic information to understand who is completing our survey as part of our work to deliver inclusive programs that appeal to everyone in our community. Only intake staff can see this information***
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First Name *
Last Name *
Email *
What Neighborhood Do You Live/Work In? *
Gender
Preferred Pronouns
Race-Ethnicity(ies). Select all that apply.
Household Income
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Age
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