CDBG PROGRAM AGENCIES/ORGANIZATIONS NEEDS SURVEY

Name of Agency/Organization:
Address
Street Address Address Line 2 City State ZIP Code
Contact
First Last
Title
Phone
Fax
Email
Brief description of programs your agency provides:
Does your organization provide any services or programs for the following?
Social/Human Services:
Housing:
Planning:
Community Development:
Economic Development:
Business Loans:
Job Training:
Other:
What clientele does your program(s) serve? i.e. low income, elderly, disabled, etc.
What are the unmet community and economic development needs in the City?
What are the unmet housing needs in the City?
What are the unmet social service needs in the City?
What, if any, are the Fair Housing issues in the City?
Comments/Suggestions (if any):

Does your organization provide any services or programs for the following?