Survey for Potential Regional Intermediaries

Note: This survey is for informational purposes only, so that potential Regional Intermediaries and potential subrecipients can connect with each other. Survey responses, including contact information, will be made public on www.census.illinois.gov.

The Illinois Department of Human Services (IDHS) is administering the 2020 Census efforts in Illinois. On July 31st, IDHS issued a Notice of Funding Opportunity (NOFO) to help ensure everyone is counted in the 2020 Census. IDHS will award grants to eligible community organizations and local governments to serve as Regional Intermediaries, using their expertise and experience in executing and managing subawards, to encourage a complete count.

Interested in Serving as a Potential Regional Intermediary?

All applicants interested in serving as a Regional Intermediary must be GATA (Grant Accountability and Transparency Act) pre-qualified by the application deadline: Friday, September 6, 2019 at 5:00 pm CT. Please visit the Pre-Award Eligibility Requirements page for step-by-step guidance on how to become pre-qualified.

Organization:

Address:

City:

ZIP:

Primary Contact

Name:

Title:

Phone:

Email:

Is your organization GATA pre-qualified? Yes No

Please select the region(s) your organization has experience in and is interested in serving. (Refer to the Census 2020 Regional Map.)

1. Central Region
2. City of Chicago
3. Suburban
4. Collar Counties
5. North Central Region
6. Northeast Central Region
7. Northern Region
8. Northwest Region
9. Southeast Central Region
10. Southern Region
11. Southwest Central Region
12. West Central Region

Please select the Hard-to-Count populations your organization has experience serving.

1. Racial and ethnic minorities
2. Foreign-born individuals
3. Renters
4. People with disabilities
5. Deaf communities
6. Persons who distrust the government
7. Homeless persons
8. Undocumented Immigrants
9. Limited English Proficiency
10. Young mobile persons
11. Lesbian, Gay, Bi-Sexual, Transgender, Queer (LGBTQ) persons
12. People who live in rural areas
13. Older adults
14. Children younger than five years old
15. Communities with limited access to broadband internet service
16. Those living close to or below the poverty line
17. Other (Specify):