We Care SurveyPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Numbers *What community or neighborhood are you from? *Is it okay to text you upcoming resources and information? *YesNoPreferred Language *Do you have a high school degree *YesNoIf NO, would you like help to get a GED?YesNoMaybe laterDo you have a job? *YesNoIf NO, would you like help with finding employment and/or job training?YesNoMaybe laterDo you need help finding daycare for your child/children? *YesNoMaybe LaterDo you think you're at risk of becoming homeless? *YesNoIf YES, would you like help with this?YesNoMaybe laterYes AND this is an emergencyDo you always have enough food for your family? *YesNoSometimesIf NO or SOMETIMES, would you like help with this?YesNoMaybe LaterYes AND I need food for tonightDo you have trouble paying for your electric and or heating bill? *YesNoIf YES, would you like help with this?YesNoMaybe Lateryes AND this is an emergencyDo you need after school services for your child? *YesNoIf YES, would you like help finding it?YesNoMaybe LaterDo you need help with transportation? *YesNoIf YES, would you like help with this?YesNoMaybe laterWhat resources, services, or events do you want to see in your community?English ClassesImmigration Information Workshops (With a Lawyer)Domestic Violence WorkshopsSelf Defense WorkshopsFinancial Literacy WorkshopsNutrition WorkshopsFamily WorkshopsWomen’s Empowerment WorkshopsFamilies Helping Families Program (Volunteering)OtherIf other, please enter hereWould you like to help us give back to the community by volunteering at events? *YesNoSubmit
