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1. How would you best describe yourself (Check all that Apply)?

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2. What is your tribal affiliation?

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3. What is your gender?

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4. What is the highest level of education you have achieved?

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5. Zip Code

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6. Which category best describes your occupation (check all that apply)?

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7. In what year were you born? (enter 4-digit birth year; for example, 1976)

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8. What makes you excited to live and work in Winnebago?

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9. If you do not work in Winnebago, why not?

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10. Check if you do any of the following business in Winnebago.

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11. Why do you think certain positions remain unfilled or have high turn over?

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12. Put any additional comments or ideas in the box.

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13. What kinds of jobs that you see in the community are available but remain unfilled? (Check all that apply)

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14. What kind of job are looking for that you cannot find in Winnebago?

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15. What needs do you see in the community that could be fulfilled with new jobs/employees? (Check all that apply)

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