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* 1. Name of organization:

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* 2. Contact phone number:

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* 3. Contact email:

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* 4. Hours of operation:

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* 5. Are you able to serve non-English speaking clients?

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* 6. Population Serviced:

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* 7. Counties Serviced:

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* 8. Services currently provided during the COVID-19 response?

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* 9. Ways to access your service?

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* 10. How has COVID-19 impacted your organization and what is your top need?

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* 11. Website:

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* 12. Contact information for the public:

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* 13. What is your clients' top need out of the services you're currently providing?

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* 14. How has this changed because of COVID-19?

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* 15. Are you a current 2019 United Way agency partner?

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