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* 1. Is your agency:

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* 2. Organization Name 

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* 3. Estimated number of people you/your agency serve each year? (if it is not known. leave blank)

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* 4. Do you/your agency have a way of identifying clients as serving in the military, service members, veterans and/or military connected family members, including children? (Please check all boxes that apply)

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* 5. On a scale of 1-5, how familiar and comfortable are you/ your agency with identifying the needs of and corresponding resources for service members, veteran and veteran families?

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* 6. On a scale of 1- 5 what is your agency's level of interaction / collaboration with other military and/or veteran-specific State, County and local resources?

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* 7. Would you/your agency like to receive FREE military/ veteran family culture training?

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* 8. Would you/your agency like to receive FREE flyers targeted to service providers on how and why to ask the appropriate questions? Please indicate which:

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* 9. Would you/your agency like to receive more information and education regarding resources and referrals for veteran clients, military connected families, customers, patients or employers who answer "yes"?

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* 10. If you are interested in receiving training on any of the above topics, please indicate the topic, your organization and contact name and your email.

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* 11. Would you like to learn more about the Orange County Veteran and Military Families Collaborative (OCVMFC) which is a coalition of service organizations that facilitates access to comprehensive services for veterans, service members and their families?

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