COMMUNITY MEMBER NEEDS SURVEY
This survey is anonymous and not connected to any personal information.
Please answer to the best of your ability.
GENERAL INFORMATION

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1. What city do you live in?

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2. How many people live in your household?

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3. What is your age?

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4. How many people living in your household are each of the following ages?

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5. What is your gender?

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6. What language do you speak at home?

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7. What is your race/ethnicity? Check all that apply.

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8% of survey complete.

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