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Customer Needs Assessment
Thank you for taking the time to fill out this assessment. Completing this form will give us the opportunity to maximize the assistance and services that we are able to offer you!
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Email
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Your email
Please provide your name.
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Your answer
Contact Numbers (Please provide best contact number first and indicate if a message phone is provided.)
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Your answer
Preferred method of contact:
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Telephone
E-Mail
Text Message
What County do you Reside In?
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Your answer
Please select the program(s) you are interested in. Please do not select a service that you have already worked with. Select all that apply.
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CERA
CARES
Early Childhood Services
Commodity Supplemental Food Program 60+
Emergency Food Assistance Program
Foreclosure
Homebuyer Education Workshop
Rental Counseling
Financial Fitness Workshop
Pre-Purchase Counseling
Budgeting Counseling
Meals on Wheels
SSVF - Supportive Services for Veteran Families
Tax Preparation - this is a seasonal program (January to April)
Bankruptcy
Head Start
Home Improvement Services
Weatherization
Down Payment Assistance
USDA Loan Packaging
Senior Luncheon
Volunteer
If you are homeless or experiencing a housing crisis, please call: (844) 900-0500
Other:
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How did you hear about NMCAA service?
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Internet/Website
Family Member
Friend
NMCAA Employee
Community Event
Other:
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Is there anything we should know when contacting your family? For example: Only call between certain hours or certain days, ect.
Your answer
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