Community Needs Assessment Questionnaire

The following questionnaire will only take a few minutes to complete and it will assist in helping people, meeting the community needs, and providing hope.  All information will be kept confidential and your name is not required on the questionnaire.  THANK YOU FOR YOUR TIME!

* 1. What is your role in the community?  (Please select the best choice which fits your role when completing this survey.)

* 3. What is your gender?

* 6. What is your ethnicity?

* 8. What is your Military Status?