Thank you for participating in our survey. Your feedback is important.

Question Title

* 1. What city do you live in/represent?

Question Title

* 2. Are you a customer or a professional?   Organization represented if professional?

Question Title

* 3. Are you (check all that apply)

What do you see as being the top needs in your community?  Please check all that apply:

Question Title

* 4. Employment/Education

Question Title

* 5. Family

Question Title

* 6. Food

Question Title

* 7. Health

Question Title

* 8. Home

Question Title

* 9. Legal Assistance

Question Title

* 10. Transportation

Question Title

* 11. Other Needs

T