Required by the Office of the Governor, Criminal Justice Division, for entities receiving OOG funds.

* 1. Please provide your contact information.

* 2. Which area of victim services or the community do you represent?

* 3. What challenges does your community face in providing services to crime victims?

* 4. How are these challenges being addressed by your agency/organization?

* 5. Are you or your agency involved in any collaborative efforts in your community? If so, please tell us.

* 6. The current Community Plan lists the following Victim's Issues. Please rank them in order of how you see their priority:

* 7. Please list other victim issues that you believe should be in the top 5 priorities:

* 8. Please explain how your agency or organization involves the community in your provision of services to victims.

* 9. Please tell us anything else regarding victim issues that is not addressed above.

T