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1st Street Improvements
City of Mandan Project No. 2019-08 Improvement District 236
NDDOT Project No. UGP-1-988(052) PCN 24136
Title VI Public Participation Survey
1.
Sex
Female
Male
Prefer not to anser
2.
Disability
Yes
No
3.
Age
Under 18
18-40
41-65
65+
4.
Race
White
Native Hawaiian or other Pacific Islander
Hispanic or Latino
Black or African American
Asian or Asian American
American Indian or Alaska Native
Other (please specify)
5.
Language most frequently spoken in your home
Spanish
German
Other African Lanuguage
Chinese
Vietnamese
Arabic
Russian
Other India Language
Japanese
Other Slavic Language
English
Other (please specify)
6.
Do you receive public assistance?
Yes
No
7.
How did you hear about this event?
Internet
Radio
Mailing
NDDOT Contact
Newspaper
Social Service Agency
Television
Advocacy Group
Other (please specify)