COMMUNITY NEEDS ASSESSMENT FORM
Due to demand fundings are exhausted at this time. We will follow up within 24hr with information on additional resources we can direct you to.Thank you, The T.R.U.T.H. Project
Name
First and last name
Your answer
Email
Your answer
Phone number
Your answer
Are you in need of shelter?
Required
Are you in need of food/water?
Required
Are you in need of clothing?
Required
Are you in need of toiletries?
Required
Are you in need of school supplies?
Required
Are you in need of physical health assistance?
Required
Are you in need of mental health assistance?
Required
Are you in need of transportation assistance?
Required
IF YOU CHECKED YES ON ANY OF THE ABOVE, PLEASE LIST ITEMS YOU ARE IN NEED OF OR WHAT KIND OF ADDITIONAL ASSISTANCE YOU REQUIRE:
Your answer
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