Department of Human Services – Union County Nonprofit Organizations Status on Essential Services during the Covid-19 Pandemic

    Please Note

    Please use Google Chrome or Mozilla Firefox when filling out this form.


    Organization Information

    Name of Organization

    What municipality is your organization located?

    Out of County Municipality

    Your Name

    Email Address

    Telephone Number


    Primary population(s) you are serving during the COVID-19 pandemic

    Check all that apply

    Other Populations


    Primary need(s) you are addressing during the COVID-19 pandemic

    Check all that apply

    Other Needs


    What type of relief services are you currently providing?

    Check all that apply


    How are services accessed by the public?

    Check all that apply and provide contact information

    On-Site Contact Information
    Virtual Contact Information
    Telephone Contact Information


    Please describe the eligibility criteria required to receive services through your organization?

    Include who may access services


    What are your hours of operation?

    Check all that apply

    Other Hours of Operation


    What are your days of operation?

    Check all that apply


    Overall, how much has the COVID-19 pandemic affected your organization?


    Please share resources and solutions that would help your organization get through this crisis


    Submit Survey