Our City’s children and youth deserve to be loved, believed in and cared for. They deserve to grow up in strong, healthy, whole communities regardless of their zip code, family background, culture, identity and ability. Currently, however, Long Beach does not have a dedicated fund for children and youth. The Invest in Youth Long Beach campaign calls for an equitable City budget that prioritizes the well-being of our future. When children and youth have the support they need to grow, learn and cope through challenging times, they are able to succeed, thrive and determine their lives! Learn more at www.investinyouthlb.org INDIVIDUAL CONTACT INFORMATION Contact Information First Name * Last Name * Street Address City Zip Code City District - None -District 1District 2District 3District 4District 5District 6District 7District 8District 9 Find your district here. State Phone Number Email Birth Date MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Year19241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024 Year Preferred Pronouns Ethnicity Select all that apply Cambodian Lao Hmong Vietnamese Thai Latinx African-American Filipino Pacific Islander White Other Ethnicity Other Personal Website Url (Optional) If you would like to use social media as an alternative way for us to contact you, please input the following optional information. Alternate Contact: Instagram (optional) Alternate Contact: Facebook (optional) Voter History Always Often Never or Not Often New- Just registered/ pre- registered I still need to register to vote I need to pre- regiester to vote (I am atleast 16 years old) I am not eligible to vote As an endorser of the Invest in Youth Long Beach Campaign, I also want to: Attend a focus group and share my input on what resources youth in my neighborhood need. Volunteer for campaign events and actions! I completed the YSP Survey (2020) PROVIDE YOUTH SERVICES and/ or EDUCATION MATERIALS that will support young people in Long Beach! ADD MY NAME to the list of endorsers on letters sent to elected officials ADD MY ORGANIZATION to the list of endorsers on letters sent to elected officials ORGANIZATIONAL ENDORSEMENT If your organization would like to endorse the Invest in Youth Long Beach Campaign, please fill out the information below. Organization Contact Organization Name Street Address City Postal Code State/Province Phone Number Website Submit
