Copy of 2019 Needs Assessment - Survey 2019 Needs Assessment Survey We value your feedback! Please take a moment to complete this survey. We will utilize this information to develop and enhance programs that most effectively meet the needs of families in our service area. OK Question Title * 1. What is your age? Under 18 18-24 25-34 35-44 45-54 55-64 65+ OK Question Title * 2. What is the number of people in your household? One Two Three Four Five Six Seven + OK Question Title * 3. What is your gender? Male Female Other OK Question Title * 4. What is your race? White or Caucasian Black or African American Asian or Asian American American Indian or Alaska Native Native Hawaiian or other Pacific Islander Multi-racial Other (please specify) OK Question Title * 5. What is your martial status? Single Married Divorced Widowed Separated OK Question Title * 6. What is your household income? No Income Under $15,000 Between $15,000 and $29,999 Between $30,000 and $49,999 Between $50,000 and $74,999 Between $75,000 and $99,999 Between $100,000 and $150,000 Over $150,000 OK Question Title * 7. Are you interested in or are struggling to increase your education? Yes No OK NEXT