Nash Edgecombe Wilson Community Action Inc. formerly known as NEED, Inc.

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 education, employment, housing, healthcare and other basic needs.
The information collected will be used to help our organization to better understand the needs in our community.

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* 1. What County do you live in ?

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* 2. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

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* 3. What is your relationship to our agency? (Select all that apply)

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* 4. Do you currently have a job?

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* 5. If Unemployed, are you currently looking for work?

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* 6. If you are unemployed, please select the reason(s) why below:

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* 7. Would you like help with these job-related activities? (Check all that apply)

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* 8. What is your primary concern in your COMMUNITY?

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* 9. Do you have childcare needs for the following age group

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* 10. Please choose from the list below what you consider to be the greatest needs in your community?

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* 11. What type of internet access do you have at home?

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* 12. Where do you usually use the internet?

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* 13. What is your approximate average household income?

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* 14. What is your housing status?

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* 15. In what language do you speak most often?

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* 16. Which race/ethnicity best describes you? (Please choose only one.)

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* 17. Which of the following best describes your current relationship status?

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

0 of 18 answered
 

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