Budget Dialogue
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1.
1
. Please tell us your contact information.
Please tell us your contact information.
Name
Street Address
email address
preferred phone number
2
. Do you rent or own your home?
Do you rent or own your home?
Rent
Own
3
. What is your gender
What is your gender
Male
Female
4
. What is your age group?
What is your age group?
18 to 44
45 to 64
65 or older
5
. Does anyone under 18 live in your household?
Does anyone under 18 live in your household?
Yes
No
6
. Please describe your employment.
Please describe your employment.
Employed in the private sector
Employed in the public sector
Self Employed
Retired
Other
7
. Are you or anyone in your household an employee of the City of Portsmouth?
Are you or anyone in your household an employee of the City of Portsmouth?
Yes
No
8
. Please describe your education.
Please describe your education.
High School education
College education
College graduate
9
. What times are you available to meet? Check all that apply.
Daytime
Evening
Sunday
*
What times are you available to meet? Check all that apply. Sunday Daytime
Sunday Evening
Monday
Monday Daytime
Monday Evening
Tuesday
Tuesday Daytime
Tuesday Evening
Wednesday
Wednesday Daytime
Wednesday Evening
Thursday
Thursday Daytime
Thursday Evening
Friday
Friday Daytime
Friday Evening
Saturday
Saturday Daytime
Saturday Evening
Sunday
Sunday Daytime
Sunday Evening
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