Unmet Needs Identification
PLEASE READ BEFORE COMPLETING THIS FORM.

This form is to capture and escalate any high-level unmet needs that exist in the Ridgefield community. This is not a formal application for assistance, but will help address unmet needs by making them known.

Form submissions will be reviewed confidentially by the Town's Long Term Recovery Committee. Thank you!
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Email *
Contact Full Name *
Contact Phone *
Job Title
Please briefly describe the unmet need (~50 words) *
Solution requested by
MM
/
DD
/
YYYY
What is the estimated population size impacted by this unmet need? (ex. 1,000 people) *
Groups most impact by unmet need *
Required
Needs Category *
Required
If there is a funding need, approximately how much is required? (Format as $XXX,XXX) *
Please describe the unmet need in detail. *
What actions have been taken to address this unmet need? *
Was this an unmet need prior to the pandemic? *
What solutions do you propose to address this issue?
Are there any supporting documents that would be helpful to address this unmet need? If you select yes, you may receive a follow-up email to obtain the documents. *
A copy of your responses will be emailed to the address you provided.
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