Intro:
Thank you for helping us with our ASCF quality of life baseline study! At ASCF our mission is to strengthen a culture of giving and improve the quality of life for all Arctic Slope region residents. It is important for ASCF to get a clear understanding of the current quality of life in our region by gathering information from every household.

The following questions are to get a general understanding of the quality of life in your community. Data collected will be congregated and used to generate statistics that will be shared on ASCF’s website. Statistics will then be used to help determine the areas of biggest need for grantmaking purposes. By completing this survey you agree to enter your name into the public raffle posted by ASCF. ASCF will keep all individual data responses confidential.

If you would like to provide any additional information, please use the text box at the end of the survey for your comments.

For every person who completes this survey you will have an opportunity to win a $500 cash prize. There will be eight $500 cash prizes, one for each community. The deadline to submit your survey is July 1st.

Requirements:
1. Must be 18 or older.
2. Must be a resident currently living in one of the eight Arctic Slope communities.
3. Must have a physical address in the Arctic Slope region.

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* 1. First and Last Name (For entering the drawing for $500)

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* 2. What community do you live in?

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* 3. Email (For entering the drawing for $500)

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* 4. Phone Number (For entering the drawing for $500)

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* 5. Street Name and House number (No P.O. Box)

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* 6. Age Range

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* 7. Gender

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* 8. Number in household

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* 9. Ethnicity

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* 10. Income level

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* 11. Employment status

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* 12. My overall quality of life is good.

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* 13. I have used programs provided by ASCF.

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* 14. My community is a safe place to live.

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* 15. We have good transportation in the community.

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* 16. We have good transportation out of the community (plane, road, boat).

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* 17. We have good air quality.

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* 18. We have enough housing in our community, and the current housing is good.

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* 19. We are prepared for large disturbances such as oil spills or natural disasters.

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* 20. We have a good landfill system and sanitation system.

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* 21. We have access to our local subsistence hunting and gathering areas.

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* 22. There are enough animals to hunt and plants to gather in our community.

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* 23. We have access to clean drinking water.

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* 24. We have access to tools for subsistence hunting and gathering.

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* 25. We want our community to be on the road system to increase access in and out of the community.

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* 26. Erosion is a concern for our community.

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* 27. Our environment is changing.

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* 28. Changes in sea ice thickness, the timing of ice formation, and break-up have made subsistence more difficult.

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* 29. My family has access to an ice cellar to store subsistence foods.

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* 30. We have good public education.

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* 31. Job opportunities are available to me.

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* 32. My income supports me and my family.

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* 33. I understand basic principles of personal finance.

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* 34. I have good social and family support.

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* 35. We have good access to nutritional foods.

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* 36. We rely on local subsistence foods.

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* 37. What percentage of your diet consists of local subsistence foods?

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* 38. We are able to store and eat local subsistence foods that have been gathered from last season.

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* 39. We have a good relationship with governmental agencies regulating decisions to hunt and gather local subsistence foods.

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* 40. We have enough store-bought food resources in our community.

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* 41. We have a good system of passing down our Iñupiaq knowledge.

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* 42. What is the level of your Iñupiaq language proficiency?

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* 43. We have enough gear and equipment to gather local subsistence foods.

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* 44. We have enough time to gather local subsistence foods.

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* 45. We have all we need to gather, process, and store local subsistence foods.

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* 46. Our search & rescue have enough resources to keep community members safe.

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* 47. There is access to mental health resources in my community.

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* 48. There is access to healthcare in my community.

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* 49. There is good quality of healthcare in my community.

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* 50. Veterinary care (animal care) is available in my community.

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* 51. We have access to exercise facilities.

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* 52. There are resources available to quit tobacco in my community.

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* 53. There are resources available to quit alcohol in my community.

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* 54. There is sex education in my community.

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* 55. (Optional) What is the biggest issue facing your community today?

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* 56. (Optional) What do you think would help improve the quality of life for your community?

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* 57. (Optional) How has ASCF impacted your community?

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* 58. (Optional) Is there anything you want to describe in more detail relating to the questions above?

Quyanaqpak!

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