Demographic Information

Instructions:  Please read carefully.  This survey was designed by the HVCCW leadership to help us collect important information from our CBO partners.  The survey should take approximately 25 - 30 minutes to complete.  

Please note if you need to SAVE the survey and RETURN at a later time:  Respondents can change their answers on any survey page until they complete the survey.  

The survey is saved after the completion of EACH PAGE.  In order to SAVE and RETURN you will need to complete the page and select "next."  Once you progress to the next page, your answers will be saved and you will be able to return at a later time to complete the survey.  If you do not save your answers on the page, they will be lost.

Respondents can return to the survey to pick up where they left off and/or edit previous responses until they click the DONE button.  In order to pick up where you left off you must open the survey using the same link and browser as you did when you started the survey.

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* 1. What is the name of your organization?

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* 2. What is the address of your organization? 

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* 3. What are your organizations hours of operation? Example:  Monday - Friday: 9am - 5pm, Saturday: Closed, Sunday: Closed

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* 4. Please provide a description of your organization here:

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* 5. What is your organizations website address?

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* 6. What is the email for your organization? (General Email for Public Contact)

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* 7. What is the main contact number for your organization?

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* 8. What is your fax number?

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* 9. What is the Twitter URL for your organization?

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* 10. What is the Facebook URL for your organization?

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* 11. What is the YouTube URL for your organization?

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* 12. What is the Instragram URL for your organization?

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* 13. What is the LinkedIN URL for your organization?

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* 14. What is the Video Profile URL for your organization?

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* 15. Please identify your sub-hub affiliation.

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* 16. Please enter the contact information for the HVCCW CBO Representative.

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