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3SquaresVT Customer Survey
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We'd love to hear about how working with a community organization helped increase your understanding of 3SquaresVT.
Your first name (optional)
What community organization did you work with? Choose one.
- Select -
Age Well Vermont
Central Vermont Council on Aging
Champlain Valley Office of Economic Opportunity (CVOEO)
Community Action in Southwestern Vermont (BROC)
Council on Aging for Southeastern Vermont (Senior Solutions)
Groundworks
Hunger Free Vermont
Northeast Kingdom Council on Aging
Southeastern Vermont Community Action (SEVCA)
Southwestern Vermont Council on Aging
Vermont Foodbank
Don’t know/Not sure
What services did you get from them? Check all that apply.
Gave me general information about 3SquaresVT.
Answered my questions about the program.
Provided a 3SquaresVT application form.
Helped me decide whether I might be eligible.
Helped me gather the info & documents I needed to apply.
Helped me to apply or complete a review.
Did these services help increase your understanding of 3SquaresVT?
Yes
No
What did you learn about the program? Check all that apply.
How you'd get your benefits (e.g., cash in bank or on an EBT card).
Where you can use an EBT card.
What you can buy with an EBT card.
How long benefits stay on an EBT card.
Your responsibility to report certain changes if you get benefits.
Other benefits you might be eligible for if you get 3SquaresVT.
Did the information provided help you decide whether to apply for 3SquaresVT?
Yes
No
Did you apply for 3SquaresVT?
Yes
No
Why not?
I decided I was likely not eligible.
My situation changed.
The application was too long.
The application asked for too much personal information.
The application was too confusing.
I felt I still needed more information about the program.
I decided I didn’t want to apply.
What could we have done to better support you through the process?
Did you feel supported during the application process?
Yes
No
How did you learn about 3SquaresVT? Check all that apply.
Community organization
Poster, brochure, flyer
Front Porch Forum
Radio, TV, newspaper
Social media (e.g., Facebook, Twitter, YouTube)
Friend, relative, neighbor
Internet search, DCF website
Other
Do you have any additional comments you want to share?
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