Burlington County Women's Survey

Burlington County Women’s Survey

Thank you for agreeing to take part in this survey so that we can better serve you and all residents in the future and ensure that we are addressing the unique needs facing women in Burlington County. This survey should only take 5 minutes to complete. Be assured that all responses you provide will be kept strictly confidential.

-Freeholder Director Kate Gibbs and Freeholder Deputy Director Linda Hughes

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* 1. Do you live or work in Burlington County? (check all that apply)

Yes, I live in Burlington County

Yes, I work in Burlington County

No, I do not live in Burlington County

No, I do not work in Burlington County

If you live in Burlington County, what town do you live in?

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* 2. Do you care for someone who lives in Burlington County (check all that apply)

Yes, I care for a child who lives in Burlington County

Yes, I care for a senior who lives in Burlington County

I care for both a child and senior in Burlington County

No, I do not care for someone who lives in Burlington County

Other (please specify)

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* 3. How long have you (or your dependent) lived in Burlington County?

Less than 1 year

1-4 years

5-10 years

Over 10 years

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* 4. What is your age range?

18-25

26-40

41-59

60-75

75 and older

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* 5. How would you best identify? (check all that apply)

Single, Head of Household

Single, Not Head of Household

Married

I have children or dependents living with me

I do not have children or dependents living with me

Other (please specify)

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* 6. What best describes your employment?

Full-time

Part-time

Business Owner

Homemaker

Unemployed looking for employment

Unemployed not looking for employment

Other (please specify)

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* 7. What is the biggest challenge you are facing finding employment?

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* 8. Do you intend to go back to work? Why or why not?

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* 9. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral.

My impression of the job market in Burlington County is good.

Please explain:

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* 10. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral or N/A.

There are adequate options for child care available in Burlington County.

Please explain:

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* 11. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral.

Burlington County offers a good variety of educational opportunities to meet to my/my family's needs

Please explain:

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* 12. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral.

I feel very connected to the community here in Burlington County.

Please explain:

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* 13. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral or N/A.

There are adequate options of access to healthcare in Burlington County.

Please explain:

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* 14. Please select which, if any, of the following Burlington County Health Department services you are aware of: (check all that apply)

Heart health & diabetic risk assessments

Lead poisoning prevention program

Flu shots and immunization clinics

Virtua community nursing services which includes prenatal, postpartum and newborn education & home visits

Women infant & children (WIC) program which provides nutritional counseling and supplemental foods to pregnant, postpartum, nursing women and their children through age 5

Communicable disease program which offers HIV/AIDS and STD counseling, testing and education, pregnancy testing, and health education information and presentations

I am not familiar with any of these services

Have you or someone you know used any of these services? What is your impression?

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* 15. Please select which, if any, of the following Burlington County Human Services you are aware of: (check all that apply)

Alcohol & Drug Abuse Unit funds alcohol and drug abuse treatment planning and programs for county residents

Division of Behavioral Health and Youth Services provides coordination, planning and funding for behavioral health, addiction and disabilities services for community needs. This division provides the many mandated committees to monitor the behavioral health system for children and adults.

The Youth Services Advisory Council (YSAC) provides the planning and funding for youth prevention programs, family crisis intervention unit, and the family engagement initiative.

Family Engagement Initiative

The Housing and Community Development provides the Home Investment Partnership

Affordable Housing Development program

First Time Homebuyer’s Program

Municipal Improvement Program

Home Improvement Loan Program

Heater Replacement Program

Emergency Home Repair Program

Code Blue Emergency Shelter Management

Social Services for the Homeless

Rapid Rehousing Initiative

Board of Social Services offers the Supplemental Nutrition Assistance Program (SNAP)

Temporary Assistance to Needy Families (CASH)

General Assistance (CASH)

Work First NJ Program

NJ FamilyCare (Medicaid)

Adult/Blind/Disabled Medicaid

Adult Protective Services

Child Support Services

Emergency Housing Services

I am not familiar with any of these services

Have you or someone you know used this service? What is your impression?

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* 16. Please select which, if any, of the following Burlington County Sheriff’s Department services you are aware of: (check all that apply)

Child safety seat checks on Wednesdays at the County Administration building in Mount Holly

Defensive driving program

Self-defense classes for women and girls

Easter egg hunt for children with special needs and developmental disabilities

Bicycle safety program

Equestrian mentoring program which offers youth who are showing signs of problematic behavior an opportunity to actively engage in character building and experiential exercises and sessions designed to empower them to make positive and healthy life choices.

Terrorism awareness program

Cyberbullying program for parents

Gang education for parents

Veteran ID cards

Gun safety locks

Internet Safety tips

An annual child toy drive

Youth police academy for children 7-12 years of age

Police and Teens Together Program youth play the role of law enforcement using lifelike video technology so they can experience the split-second decision-making required by police officers.

I am not familiar with any of these services

Have you or someone you know used this service? What is your impression?

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* 17. Please select which, if any, of the following Burlington County Military and Veterans services you are aware of: (check all that apply)

Support and guidance in accessing benefits, including: disability compensation claims, education benefits, widow’s compensation, appeals to the board of veterans and appeals

Linkage to vocational rehabilitation services

PTSD counseling

Bus service to Philadelphia

Veterans ID

Medal ceremonies

Graveside maintenance

I am not familiar with any of these services

Have you or someone you know used this service? What is your impression?

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* 18. Please select which, if any, of the following Burlington County Clerk’s Office services you are aware of: (check all that apply)

Document recording services

Passport services

Marriage ceremonies

Mail-in-ballots

Notary Public Commissions

Gold Star ID cards

Sole Proprietorship or Partnership Trade Name Registration

I am not familiar with any of these services

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* 19. Please select which, if any, of the following Burlington County Library System services you are aware of: (check all that apply)

A digital library with ebooks, audio ebooks and streaming video

Online tutorials and learning resources

DVDS

Public computer access and printing

A mobile library that visits schools, senior centers and neighborhoods

Performances and shows in a 250-seat auditorium

A summer reading program for kids

A museum pass program for free admission to over 30 area attractions

Courses in computer literacy, business, language and finance management

I am not familiar with any of these services

Have you or someone you know used this service? What is your impression?

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* 20. Please select which, if any, of the following Burlington County Workforce Development services you are aware of: (check all that apply)

Career enhancement workshops and programs

Basic skills remediation services

Job fairs

Partnership with Rowan College at Burlington County (RCBC) for job training

RCBC 3+1 Program

RCBC Training Program in Transportation

RCBC Training Program in Energy

RCBC Training Program in Manufacturing

RCBC Training Program in 911 dispatch

RCBC Training Program in Transportation, Distribution & Warehousing

RCBC Training Program in Energy & Utilities

Career advising

Tutoring services

I am not familiar with any of these services

Have you or someone you know used this service? What is your impression?

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* 21. Please select which, if any, of the following Burlington County Office on Aging services you are aware of: (check all that apply)

Meals on Wheels program

Congregate nutrition

Elder care management

Adult protective services

Long-term care management

Transportation

Money management

Homemaker/health aide services/respite

Senior farmer’s market voucher program

Physical activity programs

Outreach/public awareness

Free senior directory of services

I am not familiar with any of these services

Have you or someone you know used this service? What is your impression?

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* 22. Please select which, if any, of the following Burlington Senior Legal services you are aware of:

Free legal advice topics that include Simple Will, Power of Attorney, Medicare/Medicaid

I am not familiar with any of these services

Have you or someone you know used this service? What is your impression?

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* 23. Please select which, if any, of the following Burlington County Sheriff’s Department senior services you are aware of: (check all that apply)

Free home security surveys and safety modifications

Med-info packets

911 cellphone program

Project lifesaver program

Senior ID cards

An annual senior expo

TRIAD senior resource calendar

Senior police academy which provides seniors with valuable information on crime prevention, consumer fraud, public health issues, fire safety and more

I am not familiar with any of these services

Have you or someone you know used this service? What is your impression?

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* 24. By providing your contact information you are giving us permission to contact you regarding your survey responses. Your information and all survey responses will be kept confidential.

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 1. Do you live or work in Burlington County? (check all that apply)

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* 2. Do you care for someone who lives in Burlington County (check all that apply)

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* 3. How long have you (or your dependent) lived in Burlington County?

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* 4. What is your age range?

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* 5. How would you best identify? (check all that apply)

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* 6. What best describes your employment?

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* 7. What is the biggest challenge you are facing finding employment?

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* 8. Do you intend to go back to work? Why or why not?

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* 9. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral.My impression of the job market in Burlington County is good.

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* 10. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral or N/A.There are adequate options for child care available in Burlington County.

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* 11. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral.Burlington County offers a good variety of educational opportunities to meet to my/my family's needs

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* 12. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral.I feel very connected to the community here in Burlington County.

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* 13. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral or N/A.There are adequate options of access to healthcare in Burlington County.

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* 14. Please select which, if any, of the following Burlington County Health Department services you are aware of: (check all that apply)

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* 15. Please select which, if any, of the following Burlington County Human Services you are aware of: (check all that apply)

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* 16. Please select which, if any, of the following Burlington County Sheriff’s Department services you are aware of: (check all that apply)

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* 17. Please select which, if any, of the following Burlington County Military and Veterans services you are aware of: (check all that apply)

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* 18. Please select which, if any, of the following Burlington County Clerk’s Office services you are aware of: (check all that apply)

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* 19. Please select which, if any, of the following Burlington County Library System services you are aware of: (check all that apply)

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* 20. Please select which, if any, of the following Burlington County Workforce Development services you are aware of: (check all that apply)

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* 21. Please select which, if any, of the following Burlington County Office on Aging services you are aware of: (check all that apply)

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* 22. Please select which, if any, of the following Burlington Senior Legal services you are aware of:

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* 23. Please select which, if any, of the following Burlington County Sheriff’s Department senior services you are aware of: (check all that apply)

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* 24. By providing your contact information you are giving us permission to contact you regarding your survey responses. Your information and all survey responses will be kept confidential.

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* 25. Do you have any additional suggestions or concerns?

* 9. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral.

My impression of the job market in Burlington County is good.

* 10. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral or N/A.

There are adequate options for child care available in Burlington County.

* 11. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral.

Burlington County offers a good variety of educational opportunities to meet to my/my family's needs

* 12. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral.

I feel very connected to the community here in Burlington County.

* 13. Please read the following statement and select whether you strongly agree, strongly disagree or remain neutral. 5 is strongly agree, 1 is strongly disagree, 3 is neutral or N/A.

There are adequate options of access to healthcare in Burlington County.