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COVID-19 Charity Needs Assessment
Please help the Sheridan County Community Foundation understand your organization’s operational and charitable support needs that you are currently experiencing or anticipate experiencing in the next 60 days.
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* Indicates required question
Name of Organization
*
Your answer
Contact Name
*
Your answer
Email address
*
Your answer
Phone Number
*
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Your answer
ZIP
*
Your answer
Please select the populations you serve.
(Check all that apply)
Children
Business/Economic Development
Families
Older Adults
Persons Living in Poverty
Persons with Disabilities
Persons with Substance Dependence/Abuse
Victims of Domestic Violence
Young Adults
Other:
Please select the services you provide.
(Check all that apply)
Arts/Cultural Programming
Children Services
Counseling/Mental Health
Food
Healthcare
Medical Assistance
Recreation/Social Interaction
Support for Individuals with Disabilities
Transportation
Other:
If COVID-19 has led to a change in your operations/service delivery methods, please explain.(i.e. remote work policy, reduced hours, meal delivery as opposed to meal site, etc.)
Your answer
If your organization has had to suspend or cancel any programs or service offerings, please list them below.
Your answer
As of 3-18-2020, what are your greatest needs? (Check all that apply and explain in the next question.)
Check all that apply.
Food Supplies
Volunteers
Medical Supplies
Donations
Operational Funds
Please list all needs of your organization, including necessary supplies. Be as specific as possible. We will use this information to create an online "COVID-19 Charitable Needs List" for participating charities.
Your answer
What do you anticipate being your greatest need in 60 days?
Your answer
Have you canceled a fundraiser due to the recommendations of the CDC?
Yes
No
Clear selection
If you answered yes, what percentage of your operations is reliant on the canceled fundraiser?
Your answer
Do you intend to reschedule this canceled fundraiser?
Yes
No
Unsure
Clear selection
Please summarize which of the services you provide are seeing heightened utilization or will potentially increase as result of COVID-19.
Your answer
Our goal is to bring organizations together around a common goal of supporting our community during this pandemic. To support the larger charitable community, do you have resources that could be utilized or shared by other organizations? (Please check all that apply and then explain in the next question.)
Check all that apply.
Volunteers
Drivers
Extra Supplies
Other
Please list any resources you have that could be utilized or shared by other organizations. For example, extra supplies might include diapers or disinfectants.
Your answer
Questions/comments:
Your answer
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