Community Needs Survey Demographic Information Question Title * 1. What is your age? 18-24 25-34 35-44 45-54 55-64 65+ Question Title * 2. What is your race/ethnicity? White or Caucasian Black or African American Hispanic or Latino Asian or Asian American American Indian or Alaska Native Native Hawaiian or other Pacific Islander Another race Question Title * 3. What is your gender? Male Female Non-binary Other Question Title * 4. How many children live in your home? 1 2 3 4 5 or more No children Question Title * 5. What county do you live in? Lee County Scott County Wise County City of Norton Other (please specify) Next
