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<br /> <br />What were your unmet goals (Please circle or describe)? <br />Housing Legal Income/Employment Child Care Other: _________________________ <br />_______________________________________________________________________________________ <br />_______________________________________________________________________________________ <br /> <br />In what way can we be of further service to you? ______________________________________ <br />_______________________________________________________________________________________ <br />_______________________________________________________________________________________ <br /> <br />Do you want follow up contact? ____________________________________________________ <br /> <br />Are you interested in holiday activities such as Halloween, Thanksgiving, Christmas, etc? <br />______________________________________________________________________________ <br /> <br />Do you have any other comments for us? ____________________________________________ <br />_______________________________________________________________________________________ <br />_______________________________________________________________________________________ <br />_____________________________________________________________________________________ <br /> <br />Rate your overall stay <br />1 2 3 4 5 VERY UNHAPPY VERY HAPPY <br /> <br />Thank you for taking the time to complete this survey. <br /> <br /> <br /> <br /> <br />155