The AFN is a partnership between NAPCA and organizations that serve Asian American and Pacific Islander (AAPI) older adults and their families, aimed at strengthening the mutual delivery of service to preserve and promote the dignity, well-being and quality of life of AAPI older adults as they age. 
 
Your survey responses are critical in helping us develop and launch the Affiliate Network - thank you in advance for your time and insight! 

Question Title

* 1. Community-Based Organization (CBO) Name:

Question Title

* 2. Organization EIN:

Question Title

* 3. Organization Type:

Question Title

* 4. Contact Information - Leadership:

Question Title

* 5. Contact Information - Staff:

Question Title

* 6. Organization Website Link (if applicable):

Question Title

* 7. Organization Facebook Handle (if applicable):

Question Title

* 8. Organization Twitter Handle (if applicable):

Question Title

* 9. Organization YouTube Link (if applicable):

Question Title

* 10. What is the mission of your organization?

Question Title

* 11. What service portfolio best describes the work your organization is currently involved in? (select all that apply)

Question Title

* 12. What service portfolio (other than previously selected) would your organization be interested in exploring? (select all that apply)

Question Title

* 13. Feel free to share any additional information about the programs and services your organization provides:

Question Title

* 14. Please briefly describe the demographic of the constituency your organization serves:

  Gender Age Group  Ethnicity Income Range 
Primary Constituent
Secondary Constituents

Question Title

* 15. Please indicate the primary language spoken by the constituents your organization serves:

Question Title

* 16. Please indicate the other languages spoken by the constituents your organization serves (select all that apply):

Question Title

* 17. Please list the cities where you have remote offices or project sites:

Question Title

* 18. What benefits would you want from an Affiliate Network? (select all that apply)

Question Title

* 19. What benefits could your organization provide to the AFN? (select all that apply)

Question Title

* 20. Please indicate your interest in the AFN:

T