Fremont County Association of Governments is conducting a survey to ask you about community needs and services in Fremont County and the Eastern Shoshone Tribe. Fremont County Association of Governments is responsible for overseeing Community Services Block Grant (CSBG) funds that assist in reducing poverty, improving living conditions and increasing economic self-sufficiency for Fremont County and the Eastern Shoshone Tribe. The purpose of this survey is to provide input to Fremont County Association of Governments in determining the best use of these funds. Sheela Schermetzler of Spearfish, South Dakota is assisting them with this effort.

Thank you for taking about 5 minutes to complete this survey. You do not need to identify yourself. Please complete this online survey by Friday, January 22, 2021.

Your response is very important to Fremont County Association of Governments toward meeting the community needs in Fremont County and the Eastern Shoshone Tribe.

Also plan on participating ZOOM community meetings to discuss the needs of the low-income population in your community. Public comments are most welcome. These meetings are scheduled for the following days:

Tuesday, January 12, 2021 Hudson, 6:00PM
Wednesday, January 13, 2021 Dubois, 7:00PM
Tuesday, January 19, 2021, Eastern Shoshone Tribe, 1:00PM and Pavillion, 7:00PM
Tuesday, January 26, 2021, Lander and Shoshoni, 7:00PM
Thursday, January 28, 2021, Riverton, 1:00PM

If you would like to participate in the community meetings or if you have any questions regarding this survey please contact Sheela Schermetzler at (307) 761-2116 or e-mail sschermetzler@gmail.com or Theresa Harmati, Fremont County CSBG Coordinator at (307) 349-7768 or tharmati@wyoming.com

The final results of the needs assessment will be available May 1, 2021.

Directions: Please answer the following questions.

THANK YOU FOR YOUR TIME
PRINT/COPY THIS PAGE FOR INFORMATION ON ZOOM MEETING DATES AND TIMES

Question Title

* 1. Area of Residence and City or Town:

Question Title

* 2. Gender:

Question Title

* 3. Age:

Question Title

* 4. Ethnicity:

Question Title

* 5. Race:

Question Title

* 6. What is the highest grade that you completed in school (for adults 24 years or older only)?

Question Title

* 7. Do you have health insurance?

Question Title

* 9. Are you disabled?

Question Title

* 10. What is your family type?

Question Title

* 11. How many persons live in your household?

Question Title

* 12. How many children under the age of 18 live in your household?

Question Title

* 13. What is your approximate household yearly income?

Question Title

* 14. How is your family income provided?

Question Title

* 15. How many adults are employed in your household?

Question Title

* 16. What is the source of your family income?

Question Title

* 17. Do You?

Question Title

* 18. How much money do you spend per month on housing?

Question Title

* 19. How much money do you spend per month on groceries?

Question Title

* 20. How much money do you spend per month on Medical?

Question Title

* 21. How much money do you spend per month on Prescriptions?

Question Title

* 22. Please rank in order of priority from 10 to 1 (high to low) of what is the highest priority for your community by placing the appropriate number in each space provided so that you will rank the items 10, 9, 8, 7, 6, 5, 4, 3, 2 and 1:

Question Title

* 24. Please rank the following health problems in your community from 8 to 1 (high to low) by placing the appropriate number in each space provided so that you will rank the items 8, 7, 6, 5, 4, 3, 2 and 1:

Question Title

* 26. In the past year, has your household income:

Question Title

* 27. Why has your income increased or decreased?  Mark all that apply.

Question Title

* 28. In the past year have you had difficulty meeting expenses?

Question Title

* 29. What services did your family need in the past year? If you did not need any, respond None.

Question Title

* 30. Were the services?

Question Title

* 32. Do you know of any two or more community agencies providing the same service?

Question Title

* 33. Who do you see as a vulnerable (at-risk) population in your community and why?

Question Title

* 34. Are there any programs that would help families in your community that are not available?

Question Title

* 35. What is the greatest concern regarding your family?

Thank you for completing this survey.

T