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* 1. Please check up to 3 categories that best represents you

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* 2. Write the name of the neighborhood for the corresponding jurisdiction you reside in:

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* 3. Please indicate your employment status:

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* 4. Based on the area of the County you reside in, please rank the following options in order of importance (1 being the highest): Infrastructure

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* 5. Based on the area of the County you reside in, please rank the following options in order of importance (1 being the highest): Community Programs

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* 6. Based on the area of the County you reside in, please rank the following options in order of importance (1 being the highest): Special Needs Services

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* 7. Based on the area of the County you reside in, please rank the following options in order of importance (1 being the highest): Business and Jobs

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* 8. Based on the area of the County you reside in, please rank the following options in order of importance (1 being the highest): Housing

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* 9. Please rank the following options in order of importance (1 being the highest) provide assistance to alleviate homelessness in the County?

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* 10. Are there any additional Options not listed in Questions 4-9 that you would suggest are priorities in your area of the County. 

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* 11. Which of the following do you consider barriers to the development of affordable housing? Select all that apply:

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* 12. Do you have any additional comments or suggestions?

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* 13. How often do you use public transportation?

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* 14. If you do not use public transportation, why not? (Choose top 3 reasons)

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* 15. Total number of persons in household

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* 16. Annual Household Income

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* 17. Female-Headed Household:

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* 18. What is your age?

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* 19. Identify if you have been diagnosed with any of the following:

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* 20. Identify Race/Ethnicity

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