LUCHA -- Community Survey
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1. LUCHA -- Community Survey
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1
. What is the number one social or economic issue that negatively affects your family?
What is the number one social or economic issue that negatively affects your family?
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2
. Of the following, what is your personal, number one economic concern?
Of the following, what is your personal, number one economic concern?
Losing my home or being ‘underwater’ on my mortgage
Losing my job or not being able to find a good job
Getting underpaid or not paid at work,working an unsafe job
Having a lot of debt (like car loans or credit card debt)
Not being able to stay healthy or afford to see a doctor
Not being able to afford college tuition for my children
Other economic concern (please specify)
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3
. Are you or someone in your family currently impacted by foreclosure or being ‘underwater’ on their loan?
(at any step of the process)
Are you or someone in your family currently impacted by foreclosure or being ‘underwater’ on their loan? (at any step of the process)
Yes, I owe more for my home than it's worth
Yes, I am facing foreclosure or have lost my home
No
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4
. Do you and your family currently have health insurance? And if not, would you like it?
Do you and your family currently have health insurance? And if not, would you like it?
Yes, we have public health insurance
Yes, we have private health insurance
No, we do not have insurance AND we would like to have it
No, we don't have insurance AND we would NOT like to have it
Some members of my family have insurance and some do not
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5
. Are you or is anyone in your household CURRENTLY unemployed or underemployed?
Are you or is anyone in your household CURRENTLY unemployed or underemployed?
Yes, unemployed
Yes, underemployed
No
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6
. Has anyone in your family worked without getting paid for all of the hours, or overtime, or had a job where they were paid late?
Has anyone in your family worked without getting paid for all of the hours, or overtime, or had a job where they were paid late?
Yes, in a current job
Yes, in a previous job
No
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7
. Do you believe that higher education is affordable for your family?
Do you believe that higher education is affordable for your family?
Yes
No
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8
. Assuming your most pressing concern was being championed and fought for publicly, how likely are you to get involved at the local level to help?
Assuming your most pressing concern was being championed and fought for publicly, how likely are you to get involved at the local level to help?
Very likely to help, sign me up!
Possibly will get involved if I had the right opportunity
Unsure if I would commit, but would be open to get involved
Not likely to get involved, but you never know
Will not get involved directly / no interest
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9
. Do you want to receive text alerts, to stay up to date on community events related to these issues?
The normal charges apply according to your cell phone plan (our organizations do not charge anything).
Do you want to receive text alerts, to stay up to date on community events related to these issues? The normal charges apply according to your cell phone plan (our organizations do not charge anything).
Yes
No
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10
. My Information:
My Information:
Name
Address
Phone number
Email
Age
Number of People in Home
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