Digital@LR
Digital@LR

Customer Interaction Form – Finger Lakes

MM slash DD slash YYYY

Section 1: Customer Information

This information is to track the effectiveness of our work in the community and to demonstrate the need for our services. The personal information below is not viewable by outside individuals or agencies. We need DATE OF BIRTH and ZIP CODE for these forms to help support the funding and continuation of the program. If you do not wish to share, please place an X in those fields so that the volunteer may still record their work with you today.
Name (NOT REQUIRED)
Hidden
MM slash DD slash YYYY
No longer in use
I am a(n)... (NOT REQUIRED)

Section 2: What Was Accomplished Today

What did you practice in NorthStar?
What tasks did you complete today?(Required)
Please explain further.
If "Other" is selected, please explain in "Other computer skill or task" section below.
If "Other" is selected, please explain in "Other computer skill or task" section below.
Hidden
Workforce Readiness
Hidden
Citizenship
Hidden
Financial Literacy
Hidden
Legal
Health Literacy

Section 3: Overall Experience

Section 4: Sharing Your Success

We would like to highlight the work our program and our volunteers are doing to support the individuals in our community. Please consider sharing your success to help others see why we do what we do. You measure your own success, we are here to help you get there.
Some ideas: Job searches and employment opportunities, education goals achieved, learning a new language, finding better housing, applying to a program or service and being accepted, community involvement, etc.
This field is for validation purposes and should be left unchanged.

© 2022 Digital@LR • Privacy Policy