2019 Comprehensive Community Needs Assessment
Partner Form and Memorandum of Understanding
This Memorandum of Understanding (MOU) describes the responsibilities and expectations between the East Texas Human Needs Network and the Partner Agency regarding the 2019 Comprehensive Community Needs Assessment.
RESPONSIBILITIES AND EXPECTATIONS
East Texas Human Needs Network (ETHNN) agrees to:
Design, implement, analyze, and publish the ETHNN Comprehensive Community Needs Assessment.
Provide required Interviewer training in
Interviewing Skills and Ethical Guidelines
Provide a detailed "filtered" data report to meet the needs of your organization as requested.
Partner Agency (PA) agrees to:
Appoint a staff member as a
to be the single point of contact between your organization and ETHNN.
Assign staff or volunteers to conduct interviews, ensuring he/she goes through the required training. Please request a ETHNN volunteer if staff are not available.
Provide trained interviewer(s) access to clients.
Client participation is voluntary. Data is anonymous and confidential.
Review the results of the assessment and provide input for data analysis as it relates to your field of expertise.
The CCNA will be administered during the months of June and July of 2019.
The ETHNN and the PA may terminate this Agreement, with or without cause, with a seven (7) day written notice of termination.
This form provides organizational information including the name and contact information of the CCNA Liaison.
Indicates required field
What is the name of your organization?
If "Other", please explain
Is the Organization a 501c3?
Executive Director / CEO's Name
Executive Director / CEO's Email
The CCNA Liaison will be the single point of contact between ETHNN and your organization as it relates to the Comprehensive Community Needs Assessment.
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Signatures of authorized representatives
Partner Agency Authorized Representative
By submitting this form you are agreeing to the terms laid out in this document.
Founder and CEO
East Texas Human Needs Network
7922 S. Broadway Ave.
Tyler, TX 75703
ETHNN I 18248 Lakeside Dr., Flint, Texas 75762 I 903.216.3211