Welcome to our 2017 Community Needs Assessment

This is NOT an application for services. Community Action Partnership of Northwest Montana (CAPNM) needs your help to determine how we can best meet the needs of people in our communities. As a community member please take a few minutes to fill out the survey. Thank you in advance for your input. Please be assured that your answers are completely confidential!

* 1. What county do you live in? Check only one.

* 2. Check the top three most important needs you have today.

* 3. What barrier do you believe is keeping people in poverty in your community? Check only one.

* 4. What best describes your present housing? Check only one.

* 5. What is the condition of your current residence? Check all that apply.

* 6. Do you or anyone in your home have one of the following disabilities? Check all that apply.

* 7. List all the barriers to transportation you have experienced in the last 12 months. Check all that apply.

* 8. What best describes your current source(s) of income? Check all that apply.

* 9. Are you participating in an Employment & Training program?

* 10. Do you create a monthly spending plan/budget? If yes, how well do you stick to it:

* 11. What types of bank accounts do you have?

* 12. What is your annual/yearly income per year ($)?

* 13. If you have an emergency savings fund how large is it?

* 14. If you were in need of any services, do you know about these providers? Check all that apply.

* 15. What programs do you currently participate in/what services do you currently receive? Check all that apply.

* 16. Check all the services your or your family have utilized through CAPNM in the last 12 months. Check all that apply.

* 17. Which best describes your relationship with CAPNM?

* 18. Please indicate your overall satisfaction with assistance you've received through CAPNM.

* 19. Check all the services you or your family have an immediate need for. Check all that apply.

* 20. What is your age?

* 21. What is your gender?

* 22. What is your ethnicity?

* 23. Are you a veteran?

* 24. What is your household status?

* 25. How many times have you moved in the last 12 months?

* 26. Do you use Facebook or Twitter? (Social Media)

Thank you very much for taking your valuable time to assist CAPNM with this survey. Your input will directly impact the services we offer, and the way that we offer them. If you have any questions regarding the survey, or for more information about any of our services, please call/walk-in to one of our offices or visit us online at capnm.net.
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