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* 1. What is your agency's name?

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* 2. What is your name?

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* 3. Please select the choice that best describes your organization:

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* 4. In what county do you provide services? (please check all that apply)

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* 5. Please mark any poverty related services your organization provides (check all that apply):

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* 6. In your opinion, what are three issues that impact families that live in poverty the most?

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* 7. What services are missing in your community that could address these issues?

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* 8. Have you had to eliminate or reduce services in the past year due to reduced funding (excluding reducing services due to the coronavirus pandemic)?

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* 9. How do you think the need for services in your community might change after the coronavirus pandemic?

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* 10. Have you added to the slate of services that you provide in the past year?

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* 11. Have you had to eliminate positions in your agency in the past year due to changes in the availability or need for certain services?

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* 12. Has your organization collaborated on joint projects or provided services jointly with other agency partners in the past year?

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* 13. In your opinion, what are the strengths among agencies in your community?

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* 14. Has your program experienced any barriers to collaborating with partners?

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* 15. If so, please describe.

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* 16. Has quality affordable housing service needs changed in the past year?

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* 17. Has there been a change in the need for employment opportunities that pay a living wage  in the past year?

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* 18. How do you think the coronavirus pandemic will impact employment in your area?

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* 19. Have childcare service needs changed in the past year?

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* 20. Have teen pregnancy program service needs changed in the past year?

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* 21. Have mental health service needs changed in the past year?

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* 22. Have children's mental health service needs changed in the past year?

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* 23. Have prenatal education services changed in the past year?

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* 24. Have job training service needs changed in the past year?

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* 25. Have basic assistance (SNAP, WIC, TANF) needs changed in the past year?

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* 26. Have financial literacy service needs changed in the past year?

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* 27. Have health and nutrition program service needs changed in the past year?

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* 28. Have any other service needs changed in the past year?

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* 29. What are the gaps in services in your community?

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* 30. What are three of your community's strengths?

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