8/14/2019 ACS Needs Assessment

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ACS Needs Assessment

Please take a moment and fill out this confidential needs assessment form that will

allow us to better meet your needs. This form may be scanned and emailed to

carson.schefstad@us.army.mil , hand-carried into our office or mailed using the

postal address below.

Army Community ServiceATTN: Outreach Services

137 C Poly PlaceBrooklyn, NY 11252

718-630-4467

Please select the services you are in need of or would like more information about:(Circle all that apply)EmploymentReadiness

Program

 Job Search Resume Help Interviewing

Skills

Resources(computer lab,

fax, copier,guides)

FinancialReadinessProgram

ArmyEmergency

Relief 

CreditCounseling

BudgetManagement

ConsumerRights andObligations

VolunteerProgram

Volunteeringon Post

Volunteeringat ACS

AFAP

FamilyAdvocacy

AbuseEducation and

Prevention

DomesticAbuse

Intervention

Sexual AssaultPrevention

Child AbuseIntervention

RelocationAssistanceProgram

Loan Closet Newcomer’sOrientation

Pre-DepartureCounseling

New DutyStation

InformationEnglish as a

2nd LanguageImmigration

Services/Referral

WelcomePackets

ExceptionalFamily

MemberProgram

Advocacy Respite Care School IEPAssistance

Resources

Mobilizationand

Deployment

Briefings FRG Leader Training

SpouseBattlemind

Workshops

WaitingFamilies

Support GroupInformationand Referral

CivilianResources

MilitaryResources

LocalAttractionsandRestaurants

Army FamilyTeam

BuildingLevel I -

Survival SkillsLevel II -

 Thriving SkillsLevel III -Arriving

Skills

8/14/2019 ACS Needs Assessment

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OutreachProgram On/Off Post

AgencyReferral

EducationalResources

New SpouseOrientation

At RiskAssessment/ref 

erral

SurvivorOutreachServices

SurvivorBenefits

FinancialAssistance ,Education &

Planning

Honoring OurHeroes Events

Families of theFallen Support

GroupPlease take a minute to tell us about yourself:Status: □Active(Rank) □Retire □Family Member □CivilianGender: □Male □FemaleMarital Status: □Single □Married □Separated □Divorced □Widowed

What is the best method for ACS to get information to you? (Check all that apply)□Flyers □Bulletin Boards □Email □Website □Mailings□Facebook □Twitter □Information Kiosks around Post

What programs would you to see improved at ACS?

What programs, class topics, services do you feel are needed in the community thatACS can provide?

If you would like to be contacted regarding any of the above programs, please

include your contact information. Otherwise, you may leave this area blank forconfidentiality purposes. Thank you.

Full NameStreet AddressCity, State & Zip CodePhone NumberE-mail AddressPreferred method of contact: □E-mail □Phone □U.S. Mail