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Macedonia Community Resource Center Needs Survey
Hello neighbor! We are conducting an important community needs assessment to determine how we may provide you with
HELP
,
HOPE
, and
HEALING
. Please complete this brief questionnaire to let us know how we may support you and your household.
*
1.
Address
(Required.)
Name
*
Address
*
Address 2
City/Town
*
State/Province
*
ZIP/Postal Code
*
Email Address
*
Phone Number
*
2.
Please check the ways we may be of
HELP
(assistance)
Food / Clothing
Financial Coaching
Family or Marital Counseling
Other (please specify)
3.
Please check the things you
HOPE
for (anticipation, expectation)
Improved Family Finances
Closer Walk with Jesus / Special Prayer
A Better Understanding of God’s Word (Bible Studies)
Other (please specify)
4.
Please check the ways you desire
HEALING
(becoming whole)
Family Conflict Resolution
Help with Forgiveness / Guilt / Anger
Grief Counseling and Support
Other (please specify)
