By completing this survey, you will help towards research of understanding families' resources and needs. You will be asked to answer survey questions that include concerns, support, education, housing, and other basic needs. This will take only a few minutes of your time. The benefit of this research is that you will be helping the organizations in your community to better understand our community needs.
Thank you very much in advance for your help with the survey.

Please indicate your level of concern for the following issues/needs

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* 1. Please indicate your level of concern for the following issues/needs

  Always Often Rarely Never
Concern for safety of neighborhood
Concern for quality of housing
Need for food resources
If you have children or other dependents under your care: What is your family situation?

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* 2. If you have children or other dependents under your care: What is your family situation?

Please indicate your level of interest for a full day preschool program.

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* 3. Please indicate your level of interest for a full day preschool program.

Please indicate how each of the following impact your daily life?

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* 4. Please indicate how each of the following impact your daily life?

  Always Often Rarely Never
Obtaining Library Membership & Services
Access to Health Care/Insurance
Physical disability of a family member
Daily Nutritional Needs
Child Care
What workshop topics would you like to discuss or learn more about?

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* 5. What workshop topics would you like to discuss or learn more about?

  Yes No
Stress
Anger Management
Positive Behavior Support (Discipline)
Family Communication
Nutrition
Parenting Skills
Communication with your child's school
Math
Science
Literacy
Time Management
Other
What assistance do you need in order to accomplish goals for your family?

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* 6. What assistance do you need in order to accomplish goals for your family?

  Yes No
Need Childcare?
Need translation?
Need Transportation?
Attend meetings if childcare is provided?
Would like to learn how to read and write in English?
Would like to learn how to read and write in another language?
What days would work best for you to attend any workshops?

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* 7. What days would work best for you to attend any workshops?

  Monday Tuesday Wednesday Thursday Friday
Availability
What timeframe would work best for you to attend any workshops?

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* 8. What timeframe would work best for you to attend any workshops?

  Morning Afternoon Evening
Time of Day
What location for a workshop would be beneficial?

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* 9. What location for a workshop would be beneficial?

  Recreation Center Memorial School Mitnick School Maud Abrams School Sandman School
Location for workshop
What is the highest level of school you have completed or the highest degree you have received?

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* 10. What is the highest level of school you have completed or the highest degree you have received?

T