LIHEAP Model Plan Survey

Quapaw Nation LIHEAP PLAN

The  Quapaw Nation LIHEAP Program provides (on a first-come, first-served basis until funds are expended):
 Heating services through the winter months.
 Cooling services through the summer months.
 Crisis assistance is available when there is an immediate danger, such as:
 - Shut off notice for gas or other utility, or propane tank is empty during winter months.
 - Electric shut-off notice during summer months

Participation in this survey is greatly appreciated as we plan for the upcoming funding cycle. We value your input!
1.What is your age group?(Required.)
2.What State do you reside in?(Required.)
3.What County do you reside in?
4.Have you ever received Low Income Home Energy Assistance (LIHEAP) from the Oklahoma Department of Human Services (OKDHS), another service agency, or Tribe?(Required.)
5.Employment Status(Required.)
6.Housing Status:(Required.)
7.Number of Household Members(Required.)
8.Review the current LIHEAP plan here.  Also available on the Quapaw Nation Social Services webpage. 

Suggestions/Comments/Concerns(Required.)