Questionnaire

		Questionnaire "Help Us - Help You"

Please fill in this form and e-mail to pdowling@shorelinesoupkitchens.org or print it and mail to

Patty Dowling

The Shoreline Soup Kitchens & Pantries

P.O. Box 804

Essex, Ct 06426

Approximately how long have you been financially stressed?
What programs or assistance help you the most? (For example, “Food Stamps”)
When you first knew you were in financial trouble, what could have fixed the situation permanently? (For example, “Enough money to support my family while I finished school.”)
What would you need (practically) so that you wouldn't need any assistance anymore? (For example, "A good paying job.")
Is there something you have heard about that might help you, and you would like more information on? (For example, “ Healthcare help.”)
Right now in your life, what is your biggest problem or need? (For example, “Too much debt, or need transportation.”)
What do you think would help you get into a better situation?
What is suppose to help you, but doesn’t, and why?
Other Comments

Thank you so much for taking the time for this survey.

The Shoreline Soup Kitchens

P.O. Box 804 Essex Connecticut, USA 06426