Master Aging Plan Public Comment Survey

Thank you for your interest in the 2012-2017 Master Aging Plan!

Thank you for your interest in the Department on Aging’s 2012-2017 Master Aging Plan (MAP) for Orange County, North Carolina. This draft MAP is the culmination of a strategic planning process conducted every five years that outlines anticipated need for county government services, recommends policy and legislative changes, and identifies areas for public/private partnerships related to aging in the county. The MAP will serve as a targeted, collaborative road map for county departments to address the needs of older adults for the next five years.

The Department on Aging’s goal is to integrate the public into the strategic planning process to design a plan that reflects our local community’s vision. Your feedback is very important to us.

To begin, please provide us with some demographic information.

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* 1. What is your zip code?

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* 2. How many years have you lived in Orange County?

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* 3. Please indicate your gender.

Female

Male

Other

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* 4. Please indicate your race (check all that apply).

White

Black or African-American

Asian

American Indian/Alaska Native

Native Hawaiian or other Pacific Islander

Other (please specify)

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* 5. Are you of Hispanic, Latino, or Spanish origin?

Yes

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* 6. Please indicate your age.

21 and under

22 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 to 84

85 or older

Decline

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* 7. Please indicate the number of people living in your household.

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* 8. Please indicate your household income:

$9,999 or less

$10,000 - $24,999

$25,000 - $34,999

$35,000 - $44,999

$45,000 - $54,999

$55,000 - $64,999

$65,000 - $74,999

$75,000 or more