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Florida State Rural Development Council
Donation Need Survey

We would appreciate your input

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RURAL FLORIDA COMMUNITY DAY: DONATION NEED SURVEY


Please complete survey and return by January 15th (By FAX, MAIL or EMAIL) to:

Florida State Rural Development Council (FSRDC)
30 Research Road
Quincy, Florida 32351

FAX: 850/875-7148
EMAIL: cchanks@mail.ifas.ufl.edu

QUESTIONS: Call 1-888-FL-RURAL (toll-free)

COUNTIES YOUR ORGANIZATION SERVES: ______________________________________________
_________________________________________________________________________________

SERVICE AREAS (please check all that apply and circle your primary service area):
Advocacy
Animal rights / preservation
Arts/cultural
Child care
Disaster releif
Drug abuse / prev./treatment
Economic development
Education / literacy
Elderly services
Employment counseling
Environment
Family services
Financial / legal assistance
Handicapped assistance
Healthcare
HIV/AIDS
Hunger / homelessness
Intl. Assistance
Low-income housing
Mental health assistance
National association
Neighborhood revitalization
Non-profit assistance
Special support for women
State association
Volunteer coordination
Welfare-to-work programs
Youth services
Other

PRODUCTS NEEDED
(please circle top five priorities)
Clothing
Childrens
Womens
Mens
Furniture
Household
Office
Housing Materials
Appliances
Electrical/lighting
Housewares
Lumber
Paint
Plumbing
Power Tools
Roofing/Siding
Windows/Doors
Medical/Healthcare Supplies
Medical Equipment
Medical Supplies
Office Equipment
Computers/Printers
Copiers
Fax Machines
Office Supplies
Computer Software
General Supplies
Paper Products
Personal Care Products
Baby Care
Cosmetics
Deodorant
Shampoo/conditioner
Shaving cream / razors
Toothbrushes/toothpaste
Youth Products
Books
Recreational/Sports Equip.
Arts & Crafts Supplies
Toys
Other: