The Los Angeles City/County Native American Indian Commission’s (LANAIC) Self Governance Board (SGB) is doing this survey to learn about the social service needs of our American Indian and Alaska Native community. Please help our organization identify the top service needs by sharing your experience and opinion.

Voluntary participation: Your participation in this survey is completely voluntary. You may choose not to answer any questions. You may stop the survey at any time. There is no penalty or loss of benefits to you if you choose to do so.

What is being asked of you: If you decide to do our survey, we will ask you about your background, income, employment, and service needs. You may skip or refuse to answer any questions you like. The survey takes around 10 minutes.

Benefits to you: Your answers help local American Indian and Alaska Native agencies ensure that services meet the needs of our relatives living in poverty.

Personal information: Your responses will be kept private and anonymous. We will not ask for your name, street address, or telephone number. Your responses will be reported only as combined information and will not identify you.

Contact Information: If you have any questions about this survey and the overall goals of this project, please contact Alexandra Valdes, LANAIC Executive Director at (213) 738-3241.

Thank you for your efforts! We deeply appreciate you taking the time for this survey. Your answers will help the LANAIC’s Self Governance Board and our CSAIBG funded organizations improve services for the AI/AN community of Los Angeles.

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* 1. Are you a resident of Los Angeles County?

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* 2. Do you self-identify as American Indian or Alaska Native (AI/AN)?

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* 3. Which of the following best describes your current gender identity? Select one

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* 4. How old are you?

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* 5. Including yourself, how many people are in your household?

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* 6. What is your total household annual income level?

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* 7. What is your primary form of transportation (i.e. how do you usually get around)? Select one

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* 8. Please rank the EMPLOYMENT & JOBS services from most needed to least needed.

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* 9. Please rank the FINANCE services from most needed to least needed.

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* 10. Please rank the Health & Behavior services from most needed to least needed.

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* 11. Please rank the EDUCATION & RECREATION services from most needed to least needed.

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* 12. Please rank the HOUSING & SHELTER services from most needed to least needed.

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* 13. Are there any other services not mentioned that are critically needed for low-income American Indian and Alaska Native residents living in Los Angeles County? (ex. transportation vouchers, childcare assistance)

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