Community Action Resource Center
Intake Form
Name
*
First Name
Last Name
Job Title
Organization/Community Name
*
Phone Number
*
Please use the 10-digit number
Email
*
example@example.com
Please identify your village corporation, regional corporation, and regional non-profit organization.
Is the above organization interested in any of the following financial or administrative management support?
Compliance with Federal or State funding regulations and reporting
Grant modification and close out processes
Financial Systems management
Staff training and development
Personnel Management
Organizational Policies
New Funding Development
Community, Infrastructure, and/or Emergency Planning
Does your community have any interest in any of the resources listed below?
Early Childhood Services
Broadband Development or Equal Access to Internet
Food Assistance
Victim Services
Youth Development
Tribal Justice
Elder Engagement
Housing and/or Weatherization Services
Wellness
Other
Briefly summarize the community needs and assistance being requested:
About when is the due date for your requested assistance?
-
Month
-
Day
Year
Date
Is your community compacted?
Yes
No
Unknown
Submit
Should be Empty: