Please complete the survey below.
What is your living situation?

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* 1. What is your living situation?

What is your type of household?

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* 2. What is your type of household?

Do you or any member of your household have a disability?

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* 3. Do you or any member of your household have a disability?

If yes, is the disability

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* 4. If yes, is the disability

Do you feel you ever experienced housing discrimination while a resident of Moreno Valley?

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* 5. Do you feel you ever experienced housing discrimination while a resident of Moreno Valley?

Which of the following best describes the person you feel discriminated against you?

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* 6. Which of the following best describes the person you feel discriminated against you?

What did you feel that person did to discriminate against you?

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* 7. What did you feel that person did to discriminate against you?

Why do you believe you were discriminated against? Because of your -

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* 8. Why do you believe you were discriminated against? Because of your -

Do you know to whom you would report housing discrimination?

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* 9. Do you know to whom you would report housing discrimination?

If yes, who would you report the housing discrimination to?

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* 10. If yes, who would you report the housing discrimination to?

Please check the box that best describes your race:

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* 11. Please check the box that best describes your race:

Please check the box that best describes your ethnicity: Of Hispanic, Latino or Spanish Origin?

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* 12. Please check the box that best describes your ethnicity: Of Hispanic, Latino or Spanish Origin?

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