Which of the following best describes the organization you represent?

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* 1. Which of the following best describes the organization you represent?

What town/city does your organization operate in/cover?

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* 2. What town/city does your organization operate in/cover?

How long have you been at your organization/business?

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* 3. How long have you been at your organization/business?

What do you see as the current needs in your community, please rate each of the issues below by

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* 4. What do you see as the current needs in your community, please rate each of the issues below by

  Critical concern Somewhat a concern Not at all a concern
Food costs
Access to healthy foods
Housing /rent costs
Homelessness
Home repairs
Reducing utility costs
Increasing income
Help with managing money
Help paying utility bill(s)
Credit card or loan debt
Parenting support and education
Children’s education/tutoring
High school drop-outs
Affordable daycare or before/after school care
Neighborhood Safety and Security
Paying for college/higher education
Health Insurance/ Healthcare Costs
Dental and/or Vision Care
Programs for youth/teens
Juvenile Delinquency/Crime
Drug or Alcohol Abuse
Domestic Violence
Programs and services for Senior Citizens
Services for Disabled people
Veterans’ Services
Mental Health Services
Language Barrier(s)
Immigration/citizenship issues
Incarceration /reintegration issues
Finding a job
Job Training
Which ONE item of the list above is MOST important need right now overall in your community (or communities)?

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* 5. Which ONE item of the list above is MOST important need right now overall in your community (or communities)?

Please share any comments about the availability of services or other unmet needs in your community from your perspective? Any suggestions for improvement in services or quality of living?

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* 6. Please share any comments about the availability of services or other unmet needs in your community from your perspective? Any suggestions for improvement in services or quality of living?

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