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Clark County Community Development Block Grant (CDBG) Survey
1.
What is your most recent permanent zip code?
2.
Do you live or work in Clark County? (please select all that apply)
Rent primary housing in Clark County
Own a primary residence in Clark County
Work in Clark County
Own commercial property / rental property in Clark County
I do not live or work in Clark County
3.
What race do you identify with?
White
Black or African American
Asian or Asian American
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
Other / Multi-racial
Prefer not to answer
4.
Do you identify as Hispanic or Latino?
Yes
No
5.
What is your age?
6.
How do you identify?
Male
Female
Other
Prefer not to answer
7.
Are you a person living with a disability?
Yes
No
Spouse or child has disability
8.
What is your annual household income?
1 person household - $66,100 or less
1 person household - $66,101 or more
2 person household - $77,550 or less
2 person household - $77,551 or more
3 person household - $85,000 or less
3 person household - $85,001 or more
4 person household - $94,400 or less
4 person household - $94,401 or more
5 person household - $102,000 or less
5 person household - $102,001 or more
6 person household - $109,550 or less
6 person household - $109,551 or more
7 person household - $117,100 or less
7 person household - $117,101 or more
8 person household - $124,650 or less
8 person household - $124,651 or more
9.
Do you have internet at your place of residence?
Yes
No
10.
If you have internet in your home, please specify what type of internet.
Cable / Broadband
Satellite
Cellular / 5G
I don't know
11.
What do you believe are the greatest housing needs in Clark County?
12.
Including special services, community facilities and infrastructure, what do you believe are the greatest
non-housing
needs in Clark County?
13.
Federal basic fair housing requirements prohibit discrimination in buying, selling, renting or lending based on race, color, religion, sex, disability, nationality or familial status.
Do you believe discrimination is an issue in Clark County?
Yes
No
I don't know
14.
If you or someone you know have ever experienced housing discrimination, please select all of the following that apply.
Housing provider refused to rent or deal with a person
Housing provider falsely denied that housing was available
Housing provider refused to make reasonable accommodations for a tenant with one or more disabilities
Housing provider used discriminatory advertising
Real estate agent refused to sell or deal with a person
Real estate agent directed people to certain neighborhoods
Housing mortgage lender discriminated by denying mortgage
Housing lender directed people to certain neighborhoods
Different terms and conditions were provided for renting based on race of the tenant
Not Applicable
Other (please specify)
15.
On what basis do you believe you or someone you know was discriminated against (select all that apply)
Race or ethnicity
Color
Religion
Disability
Gender
Family status (single, divorced, children, expecting a child)
Sexual orientaion
National origin
I don't know
Not Applicable
Other (please specify)
16.
If you believe you have been subjected to discrimination, have you reported the incident?
Yes
No
Not applicable
17.
If "no" to the above question, please select all reasons that apply
Do not know where to report
Afraid of retaliation
Too much trouble
Do not believe it would make a difference
Other (please specify)
