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Communities Connected for Success (CC4S)
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Intake form
Help us serve you better
Name
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Email address
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What services are you interested in?
Please select at least one option.
Workforce Development
Community Relations
Student and Family Development
Life Skills Enhancement
Mental Health Resilience
What is your primary goal?
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Economic Growth
Community Engagement
Youth Development
Skill Building
Mental Health Support
How did you hear about us?
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Social Media
Word of Mouth
Event
Online Search
Referral
Are you representing an organization?
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Yes
No
If yes, please provide the organization's name.
What age group do you represent?
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Children (0-12)
Teens (13-19)
Young Adults (20-24)
Adults (25+)
What specific challenges are you facing?
Would you like to participate in events or workshops?
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Yes
No
What type of collaboration are you interested in?
Please select at least one option.
Partnerships
Volunteering
Sponsorships
Donations
Workshops
Which service or services are you interested in?
Please select at least one option.
Workforce development programs
Community engagement initiatives
Mental health resilience workshops
Additional questions or comments
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