SVdP Reporting - NCT

Monthly reporting form for neighbor contact teams
    Select one
  • Date Format: MM slash DD slash YYYY
    This is your last day of service and should be a Sunday date.
  • In the preceding month (including the week just
    past), how many home visits were made?
  • How many individual households were aided, either with physical assistance or other assistance?
  • How many adults reside in those households receiving assistance?
  • How many children reside in those households receiving assistance?
  • Including gift cards, what is the total dollar
    value of the assistance that was given?
  • Please enter a number greater than or equal to 56.
    How many hours were spent,
    including time spent monitoring the phone
  • How many miles were driven during the course of delivering assistance; include miles to/from food pantry
  • Please enter your email address above
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