Census 2020 Pledge Form

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We all count. We all matter.

Please correct the field(s) marked in red below:

Pledge to participate in the 2020 Census!

The 2020 Census will determine the resources and representation in ouc community for the next ten years.

Let's get Richfield counted! 

1
Name: 
2
Address:
3
Email Address
4
Phone Number (if you would rather be contacted by phone):
5

Do you pledge to participate in the 2020 Census and be counted?

  1. To receive a copy of your submission, please fill out your email address below and submit.
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