Orcas Community Resource Center Client Intake Form Logo
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  • Client Intake Form

    Orcas Community Resource Center
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  • Contact Information

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  • Demographic Information

    Why do we ask? This information helps us access grants and other funding opportunities to better serve you!
  • What brings you to the Resource Center today?

  • Housing


  • Employment


  • Household Information

  • Support Network

  • Local Resources

  • Life Evaluation: The Cantril Ladder

    The top of this ladder represents the bestpossible life for you, whatever “prospering” looks like in your eyes. The bottom of the ladder represents the worst possible life for you (as the ladder says… “hopeless”).
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  • My signature below indicates that all of the information on this form is both true and accurate. OCRC may use this information to determine elibility for programs and benefits as well as provide data to determine local, county, and state program needs. OCRC may transfer the information contained within this document to their private database. OCRC will not use the information contained in this application for any other reason without my written consent.

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