Initial Contact Sheet
Full Organization Name:
Organization Zip Code:
Primary contact name for outreach?
Primary Contact Email:
Primary Contact Phone Number:
Secondary contact name for outreach?
Secondary Contact Email:
Secondary Contact Phone Number:
Which County Supervisorial District is your organization located in?
Supervisorial District 1
Supervisorial District 2
Supervisorial District 3
Supervisorial District 4
Supervisorial District 5
Unincorporated Areas
Which description/demographic group best aligns with your organization's mission? Please select all that apply:
AAPI
Arts Education
Black or African American
Formerly incarcerated
Hispanic or Latino/a/e/x Groups
LGTBQ+
Mental Health Support
Native American or Indigenous
Senior groups
Social Services/Justice
Under resourced groups
Youth groups
Other
If other, please describe: