The

Democratic Republic of Congo, Community

of Arizona Census Questionnaire

The Democratic Republic Congolese Community of Arizona Community

Census Questionnaire

Purpose:

This form helps us understand the demographics, needs, and interests of our

Congolese community in Arizona so we can better serve and connect everyone.

All information will remain confidential.

This form helps us understand the demographics, needs, and interests of our Congolese community in Arizona so we can better serve and connect everyone. All information will remain confidential.

Section 1: Personal Information

Full Name

Gender

Male
Female
Prefer Not to Say
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Date of birth

Phone *

Email *

City of Residence in Arizona:

Section 2: Family Information

Marital Status:

Single
Married
Divorced
Widowed
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How many children do you have?

Do you live with your family in Arizona?

Yes

No

If no, where is your family currently living?

Section 3: Origin and Background

Province of Origin in D.R. Congo:

Ethnic Group / Language Spoken at Home:

Languages Spoken Fluently:

French

Swahili

Lingala

Tshiluba

English

Other

Other (Language)

How long have you lived in Arizona?(years)

Section 4: Education and Employment

Are you currently employed?

Yes

No

Highest Level of Education Completed:

Primary

Secondary

College

University

Graduate School

Vocational Training

Occupation / Type of Work:

Do you own a business?

Yes

No

If yes, what type of business?

Section 5: Immigration and Status

Year You Arrived in the United States

Immigration Status:

U.S. Citizen

Permanent Resident

Refugee / Asylee

Student Visa

Work Visa

Other

Other (immigration status)

Section 6: Community Engagement

Are you a registered member of the Congolese Community of Arizona?

Yes

No

Have you participated in community events before?

Yes

No

What types of activities would you like the community to organize?

Cultural Events

Youth Programs

Job Support

Education Workshops

Sports

Family Gatherings

Other

Other(activitie)

Would you be interested in volunteering or joining a committee?

Yes

No

Section 7: Religion and Church Involvement

Religion:

Christian

Muslim

Other

Other(Religion)

Church You Attend (if any):

Section 8: Social and Economic Needs

What are the main challenges you face in Arizona ?

Employment

Housing

Language Barrier

Legal Issues

Transportation

Health Care

Education

Other

Other(Chllenge)

What kind of support would you like from the Congolese Community?

Job Opportunities

Business Support

Legal Help

Networking

Family Support

Youth Mentorship

Other

Other(support)

Section 9: Future Involvement

Would you like to participate in community leadership or committees?

Yes

No

Would you like to receive community updates via email or WhatsApp?

Yes

No

Section 10: Comments or Suggestions

Please share any additional comments, ideas, or suggestions:

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Uniting, empowering, and uplifting Congolese families in Arizona since 2001.

Quick Links

Contact

+1 623-308-6276

Location

Phoenix, AZ, USA

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