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1. What is your gender?

2. How many children do you have?

3. What is your marital status?

4. Are you currently employed?

5. What is your income level/range

6. Are you currently or have you received federal government assistance programs such as TANF, Food Stamps, Daycare assistance, or health insurance, if so please click all that apply

7. Have you used any paid child care services for your child or children such as childcare centers or home daycare?

8. If you identify as a single parent, what do you find to be the most challenging about being a single parent? Please click all that apply.

* 9. What are some of assumptions or stereotypes associated with being a single parent?

* 10. As a single parent, what type of services would like to see become available to you and your family?

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