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Community survey for the Jewish Family Service Agency

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jhp000285-002
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Dear Friends: The Jewish Family Service Agency is committed to giving assistance to those in need and to preserve and enhance family life. You can be great help to the Jewish Family Service Agency by providing us with information that will allow us to im-prove delivery of needed services to the Las Vegas community. Be assured that the data you provide will remain con-fidential. Our intent is simply to examine your response to the questionnaire printed below along with those received from our clients. It is our intention to quantify the results, improve those areas that we are capable of and perhaps include some of your observations into our "Long Range Planning Process" currently being worked on. We thank you in advance for your cooperation and time devoted to help-ing us. Please cut out this questionaire and mail to JFSA. Sincerely, Bernie Kaufman, President COMMUNITY SURVEY Please answer each of the following questions by filling in the appropriate in-formation. Age: Sex: Male Female Marital Status: Single Separated Divorced Widowed Do you have children? Number Ages? 0-15 15-21 Over 21 How many years have you lived in the Las Vegas area? Are you affiliated with a religious or-ganization? Yes No Synagogue or Church Education: (check highest level) Grade School High School Some Collage or Trade School Bachelor's Degree (or equivalent) Master's Degree (or equivalent) Ph. D, M.D., etc. Zip Code of Residence Services You Might Be Interested In! Counseling Life Supportive Services Transportation Home Caring Assistance Shopping Money Management Medical/Psychiatric Aftercare Immigration Adoption Service Big Brother Housing Information Are you aware of the existence of Jewish Family Service Agency? Yes No