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We want to hear from you! By completing this survey, you are helping inform local nonprofit service providers, government officials, community groups, and your neighbors about the true needs of Cape Ann’s residents as we all face COVID-19 together.

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* 1. Where do you live?

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* 2. What do you think are the top needs impacting people in your community since COVID-19? Check ALL that apply.

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* 3. Compared with three years ago, are you and your family better off, worse off, or about the same?

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* 4. Are you able to pay your bills on time each month?

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* 5. Are you concerned about paying your bills?

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* 6. Do you currently have at least $500 set aside for emergencies?

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* 7. What keeps you or your family from feeling more financially stable right now? Check ALL that apply.

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* 8. What is your employment status?

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* 9. Are you an essential worker?

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* 10. What is your housing situation?

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* 11. Are you worried about being evicted?

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* 12. Have you or anyone in your family accessed services through Action Inc. in the last year?

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* 13. What is your age?

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* 14. What is your gender, as you define yourself?

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* 15. What is your race? (Please check one.)

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* 16. Are you Hispanic/Latino?

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* 17. What is your household’s monthly income before taxes?

Include: Wages, TANF, Social Security, Disability Benefits, etc. Do NOT Include: Food Stamps (SNAP), WIC, MassHealth, Other Public Health Insurance, Fuel Assistance, etc.

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* 18. How many people are in your household including yourself?

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* 19. Contact Information (optional)

If you provide contact information, you will have a chance to win a $25 Market Basket gift card. Your contact information will not be used for any other purposes.

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