White House Council on Environmental Quality
Environmental Justice Community Engagement Survey

We invite you to complete the short survey below so we can keep you up-to-date on our work, communications, and on-going engagement with community members and stakeholders.

If you have any questions, please email ej@ceq.eop.gov.  Thank you!
1.First Name(Required.)
2.Last Name(Required.)
3.Email Address(Required.)
4.Phone Number
5.City
Where are you located? Please include city?
6.State
Where are you located?  Please include state or territory. 
7.Issue Areas
Please select the issue area(s) that most align with your organization’s mission and work. Check all that apply.
(Required.)
8.Area of Work
The previous question offers only broad categorizations of your organization’s area(s) of interest and work. You may provide more information here, so we can better tailor our engagement with you and your organization. For example, if you selected “Water” in the previous question, this question provides an opportunity to specify what type of water issues you work on, including access to safe drinking water, water conservation, water rights, etc.
9.Organization Name
What is the name of your organization? If not applicable, write N/A.
10.Scale of Work
At what scale does your organization’s work focus upon? Check all that apply.
11.Organization Website
If applicable, please include a link to your organization’s website.
12.Constituency
What communities do you work with or serve? For example, youth, Tribes, rural communities, communities of color, etc.(Required.)
13.Would you like to receive updates from CEQ? 
CEQ will periodically send out announcements about relevant webinars, listening sessions, and funding opportunities available across the Federal government.(Required.)