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* 1. State

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* 2. Name

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* 3. Email Address/Phone

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* 4. Have you seen a change in the number of LIHEAP applications you have received this year?

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* 5. What is the status of your LIHEAP budget?

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* 6. Have you made/do you plan to make any changes to your program this year in response to your current budget status (e.g. raise/lower benefit levels, supplemental benefits, add/eliminate or increase/decrease funds for certain components, etc.)?

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* 7. If your program received 10% more funding, what would you do with the extra funds?

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* 8. What is your biggest concern about your LIHEAP this year?

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* 9. What are you working on changing/updating/improving in your program? Could be anything – database, new pilot/partnership, outreach strategy, tribal/vendor/local agency management, etc.

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* 10. Is there anything going on at the state level that is affecting/could affect your LIHEAP or the way you run your program?

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