Community Needs Assessment Survey

CEDA, along with all other community action agencies in Illinois, is conducting a study of the needs individuals and families may be experiencing in their lives.  Results from the study will be considered by the community action agencies for planning, developing, and delivering agency programs, services, and activities.      
 INSTRUCTIONS:  Please answer each question by checking the appropriate box (or boxes) or providing a written response.  

                   All surveys will be kept confidential.  Thank you for participating.

* 1. What is your household's zip code?

* 2. What is your age?

* 3. Gender?

* 4. Household Type?

* 5. EMPLOYMENT: Which employment needs could you use help with?  (select all that apply)

* 6. EDUCATION:  Which education needs could you or a family member use help with? (select all that apply)

* 7. FINANCIAL AND LEGAL ISSUES:  Which financial and/or legal needs could you or your family use help with? (select all that apply)

* 8. HOUSING: Which housing needs could you or your family use help with? (select all that apply)

* 9. FOOD AND NUTRITION:  Which food and nutrition needs could you or your family use help with? (select all that apply)

* 10. Do you have children (under the age of 18) living with you?

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