JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Customer Feedback
Please tell us about your experience with us!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name
*
Your answer
What services were you assisted with?
*
Food Pantry
Help with rent so I will not be evicted
Help with my electric or fuel bill
Help with support services including uniforms/work attire, tools, tutoring, transportation.
Holiday Angels - gifts for my children
Tax Preparation
Other:
Were you happy with the services that you received?
*
Yes
No
Required
Did you visit the Family Center because of challenges experienced as a result of COVID-19?
Yes
No
Please tell us about your experience with the Family Center and how we can further assist:
Your answer
We appreciate you!
We hope you are satisfied with our services and appreciate your feedback.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Community Action Planning Council.
Report Abuse
Forms
