The United Way and PNC Are Here to Help You!

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* 1. What is your age?

15-24

25-35

36-45

46-54

55-64

65-74

75+

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* 2. Number of members in household.

Over 18

Under 18

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* 3. What is your race or ethnicity?

Black or African American

Hispanic or Latino

Middle Eastern or North African

Multiethnic

Native American or Alaska Native

Pacific Islander

White

Other (please specify)

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* 4. Type of employment?

Student

Unemployment

Full Time Employment

Unemployed

Part Time Employment

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* 5. Which of the following best describes your current relationship status?

Married

Widowed

Divorced

Separated

Partnership

Single but cohabitating with a significant other

Single, never married

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* 6. Which services are you interested in learning more about?

Debt Consolidation

Food Assistance

Banking Assistance (checking, savings, debit card)

Rental Assistance

Free Legal Services

Child Care

Utility Assistance

Financial Assistance

Other (please specify)

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* 7. Transportation affects my child(ren)'s ability to attend daily Boys and Girls Clubs programs.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Comments

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* 8. Boys and Girls Clubs program hours are convenient for my family.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Comments

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* 9. Please note this meeting has been moved to Heart Reach Neighborhood Ministries located at 211 Rodondo Road, Youngstown, Ohio.

I will attend the United Way and PNC financial education and resource workshop at the Heart Reach Neighborhood Ministries on October 25, 5:00-6:00 p.m.

Yes

I am unable to attend but would like someone to contact me about: (Please include your name and phone number)

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* 10. Date

Date / Time

Date

The United Way and PNC Are Here to Help You!

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* 1. What is your age?

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* 2. Number of members in household.

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* 3. What is your race or ethnicity?

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* 4. Type of employment?

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* 5. Which of the ﻿following best describes your current relationship status?

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* 6. Which services are you interested in learning more about? ﻿

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* 7. Transportation affects my child(ren)'s ability to attend daily Boys and Girls Clubs programs.

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* 8. Boys and Girls Clubs program hours are convenient for my family.

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* 9. Please note this meeting has been moved to Heart Reach Neighborhood Ministries located at 211 Rodondo Road, Youngstown, Ohio. I will attend the United Way and PNC financial education and resource workshop at the Heart Reach Neighborhood Ministries on October 25, 5:00-6:00 p.m.

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* 10. Date

* 5. Which of the following best describes your current relationship status?

* 6. Which services are you interested in learning more about?

* 9. Please note this meeting has been moved to Heart Reach Neighborhood Ministries located at 211 Rodondo Road, Youngstown, Ohio.

I will attend the United Way and PNC financial education and resource workshop at the Heart Reach Neighborhood Ministries on October 25, 5:00-6:00 p.m.