By completing this survey, you will help Community Action Commission (CAC) understand the needs of people living in Santa Barbara County, the resources available to them, and the services that are still needed.  This information will help CAC ensure that services are properly focused and will help us work in partnership with other agencies to address the greatest needs.  You will be asked to answer questions that include education, employment, housing, healthcare and other basic needs.  The survey will take approximately 15 - 20 minutes of your time.

There are no risks to you for participating in this study, and no penalty for not participating. All information will be kept confidential and your name is not required on the questionnaire. Thank you for your time!

Para español por favor haga clic aquí: http://bit.ly/CACCNAsp

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* 1. In what city or town do you live?

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* 2. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

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* 3. How many people currently live in your household?

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* 4. Which of the following best describes you and your family?

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* 5. Indicate the number of persons in each age range currently living in your household.

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* 6. Please indicate your gender.

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* 7. Which category best describes your age?

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* 8. Are you or a member of your household a former or current member of the Armed Forces, Military, or Military Veteran?

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* 9. Are you or anyone in your household disabled?

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* 10. Do you provide regular UNPAID caregiving or assistance to help a family member or a friend?

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* 12. Please choose an option that best describes your ethnicity.

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* 13. Which race best describes you?

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* 14. In your home, what language is spoken most often?

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* 15. Please indicate the highest level of education in your household

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* 16. Which of the following categories best describes your employment status?

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* 17. Are you a college student?

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* 18. Please check all sources of income that contribute to your household.

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* 19. Please select the option that best describes your annual  HOUSEHOLD income. (Gross - before taxes)

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* 20. Please select your current type of housing.

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* 21. Do you have reliable transportation?

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* 22. What is your primary means of transportation?

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* 23. Do you currently have a bank account? (Checking and/or Savings)

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* 24. Do you use Check Cashing or Cash Advance services?

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* 25. What are the top five challenges that personally impact you or anyone in your  HOUSEHOLD?

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* 26. What are the five most important needs or concerns right now for people living in  SANTA BARBARA COUNTY?

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* 27. Do you currently participate in programs at Community Action Commission?

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* 28. If so, which Community Action Commission services have you or a member of your household used? Please check all that apply:

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* 29. To what extent do you think the people you know are aware of Community Action Commission's programs and services? Are they aware of:

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* 30. Which of the following best describes your relationship with Community Action Commission?

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* 31. Do you have access to the internet?

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* 32. If YES, where do you connect to the internet most?

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* 33. Do you have access to a phone?

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* 34. If you do have access to a phone, please check all that apply.

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* 35. Do you have an e-mail address?

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* 36. Do you use social media?

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* 37. If YES, which social media sites do you use?

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* 38. Where do you go to learn about services in the community? Check all that apply:

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* 39. Please use the space below to share additional comments, concerns or information about your needs, and/or the needs of Santa Barbara County Residents.

Thank you for taking the time to complete this survey.  If you would like more information about Community Action Commission, please visit www.cacsb.org

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