2. Email address*
4. First name*
6. Last name*
8. Phone number
10. Are you a member of any of the following community groups/organizations? (Please check all that apply)

    1. SOMA Board of Education
    2. LGBTQIA Community
    3. Neighborhood/Block Association
    4. Parent Groups
    5. Small Business Organizations
    6. Artist Groups
    7. Educational Groups
    8. Veteran Groups
    9. Athletic Groups
    10. National/Ethnic Organizations
    11. Senior Citizen Organizations
    12. Health Organizations
    13. Technology Groups
    14. Science Groups
    15. Faith Based Community (Church, Temple, Mosque, etc...)
    16. Other
12. If you checked "other", please list the organizations you belong to that are not represented on the list above.
14. Would your community group(s)/organization(s) be interested in learning more about the Census or hosting an information session?

    1. Yes
    2. No
    3. Maybe
16. How do you think the Township of South Orange can best reach residents to teach them about the Census?
18. Thank you for taking the time to respond to this form and for your interest in learning more about the Census. We will be sure to keep in touch with you as we seek to ensure that South Orange is accurately counted in the 2020 Census!
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20. 1. Receive an email copy of this form.
21. Email address

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22. Submit

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