CASH Questionnaire 2023

Question Title

* 1. Contact Information - if no email, write n/a

Name

Email Address

Phone Number

Question Title

* 2. How did you hear about CASH

Radio

Direct Mail/Post Card

Another client of CASH (Family/Friend)

Social Media

Community Organization/ Non-Profit Partner

Other (please specify)

Question Title

* 3. Please check the one that best describes you:

Couple filing joint

Female

Male

Other (please specify)

Question Title

* 4. what is the reason for your visit to CASH

Tax Preparation

IRS or NYS letter

Question about a Tax Return

Other Reason

Question Title

* 5. Please select the one that best describes you:

African American or Black

Caucasian or White

Hispanic or Latino

Asian

Native American or Alaskan Native

Native Hawaiian / Other Pacific Islander

Two or more race/ethnicities

Other race/ethnicity (not listed)

Question Title

* 6. Would you like to be a CASH Volunteer? Volunteers are required to utilize an email account.

Yes - I can volunteer this year (now)

Yes - I can volunteer next year (Next Tax Year)

Question Title

* 7. ROC Your Family’s Future Project:
We are looking for taxpayers claiming the Earned Income Tax Credit for the FIRST time to participate in this project. Eligible participants are asked to complete a survey and will receive a $25 Wegmans gift card. Are you interested in learning more?

Yes - CASH Staff will follow-up

Unsure - Need more information

Question Title

* 8. Our mission is to make our community a place where all people thrive by providing access to financial guidance, education, and resources. Would you be interested in a savings initiative that will help you to evaluate your credit and identity individualized financial goals.

Yes - Financial Empowerment Staff will Follow-up

No - Not Interested

No Answer

Question Title

* 9. Do you and your family have health insurance

Yes

No - someone from Fidelis Care will reach out to you

No Answer

Question Title

* 10. If yes to question above, are you happy with your Insurance?

Yes

No- someone from Fidelis Care will reach out to you

No Answer

Question Title

* 1. Contact Information - if no email, write n/a

Question Title

* 2. How did you hear about CASH

Question Title

* 3. Please check the one that best describes you:

Question Title

* 4. what is the reason for your visit to CASH

Question Title

* 5. Please select the one that best describes you:

Question Title

* 6. Would you like to be a CASH Volunteer? Volunteers are required to utilize an email account.

Question Title

* 7. ROC Your Family’s Future Project:We are looking for taxpayers claiming the Earned Income Tax Credit for the FIRST time to participate in this project. Eligible participants are asked to complete a survey and will receive a $25 Wegmans gift card. Are you interested in learning more?

Question Title

* 8. Our mission is to make our community a place where all people thrive by providing access to financial guidance, education, and resources. Would you be interested in a savings initiative that will help you to evaluate your credit and identity individualized financial goals.

Question Title

* 9. Do you and your family have health insurance

Question Title

* 10. If yes to question above, are you happy with your Insurance?

* 7. ROC Your Family’s Future Project:
We are looking for taxpayers claiming the Earned Income Tax Credit for the FIRST time to participate in this project. Eligible participants are asked to complete a survey and will receive a $25 Wegmans gift card. Are you interested in learning more?