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* 1. Which describes you:

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* 2. What is your gender?

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* 3. What is your race?

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* 4. What is your ethnicity?

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* 5. What is your Age Group

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* 6. What is the highest level of school you have completed or the highest degree you have received?

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

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* 8. Housing Status:

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* 9. What is Your Family Situation?

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* 10. Have you used any Clinton County Community Action Programs in the past 12 months?

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