NAACP Student and Family Questionnaire
The local NAACP and our partners are trying to establish what the needs of our community are and how can we best serve them during this time.
Email Address /Phone Number (Preferred means of contact)
What is your current employment status?
How many people are in your household?
How many are under the age of 18?
Which part of Lane county do you live?
Within Eugene city limits
Outside Eugene city limits
What are you families immediate concerns?
What type of services/supplies would your family like to receive?
Books (Pre-k through Elementary)
Food (Perishable and non-Perishable)
Student Sack Lunches
To receive supplies, which way would be most preferred/easiest for your family?
On site pick up at Mims House (NAACP Office)
Delivery/Drop off at your house
Pick up at student's schools
Are there any suggestions for fun or entertaining services/items the NAACP can provide for students and families cooped up at home?
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This form was created inside of NAACP Branch 1119.