PICCA Strategic Plan Survey

Please assist the organization by providing information regarding community needs. All responses are anonymous and sent to a 3rd party collector.

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* 1. Please share your relationship to the organization.

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* 2. Please provide your zip code

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* 3. How many people live in your home?

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* 4. Which county do you reside in?

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* 5. Please share your age.

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* 6. What are the greatest needs in the area of Housing? Choose only 5 areas.

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* 7. Health care needs. Choose only 5 areas.

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* 8. What are the greatest areas of need in education? Choose only 5 areas.

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* 9. What are the greatest areas of needs in employment? Choose only 5 areas.

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* 10. What are the greatest needs of Seniors? Choose only 5 areas.

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* 11. What are the greatest needs of children? Choose only 5 areas.

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* 12. Please check the top 4 answers in income and asset building? Check only 4.

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* 13. What is the greatest food needs? Choose only 5 areas.

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* 14. Overall community/county needs as a whole needing addressed? Choose only 5 areas.

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* 15. What township do you reside in?

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* 16. Please feel free to take the opportunity to share any needs that the community and organization should focus on in the future.

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* 17. Are you familiar with the services of Pickaway County Community Action Agency?

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