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1) What is the Town or City of your business? (click the drop-down arrow to select...


and zip code


2. Which of the following best describes the organization you represent:

Healthcare Provider

3. Does your organization/business invest in the community where it is located in any of the following ways? (check as many as apply)

Have not done so

4. How long has your organization been in the community? (select one)

1-5 years

5. Does your organization recruit employees from the community in which it is located?

Don't know

If yes, approximately how many of your employees reside in the community?


6. Does your organization currently refer customers or employees to CEDA?


7.  Based on the current needs of your community, please rate each of the issues below.

Transportation (check one of the ratings please)


Food costs


Access to healthy foods


Housing / rent costs




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 of 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/re-integration issues


Finding a job


Job Training


Other: (other concerns)


8. Which ONE item of the list above is the MOST important need right now?


9. Thinking about the resources and programs that already exist, how would you rate the following services in your community? (Please check one rating per item)

Job Training and Employment


Quality Education


Affordable Housing


Foreclosure Prevention


Healthy Food /Grocery Stores


Financial Education & Services


Medical & Dental Care


Programs / Activities for Youth


Child Care




Mental Health  Services


Veteran's Services


Homeless Services


Immigration and Citizenship


Alcohol & Drug Treatment


10.  Any other comments or suggestions.

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Created at 11/19/2020 5:41 PM by ***
Last modified at 11/19/2020 5:41 PM by ***