Tell Us About You & Your Family

Thank you for completing this survey! It is designed to help us better serve you and our community. 
We will ask you:

-about yourself and your household
-about your general well-being
-about some key areas of interest, like employment & transportation
-about what you think your community needs
-about your relationship with our agency

It is really important to us to get your feedback, so please answer the full survey. It should take about 15-20 minutes. You are free to decline to answer any particular question you do not wish to answer for any reason.

Your survey answers will be sent to a link at where data will be stored in a password protected electronic format. We do not require identifying information such as your name, email address, or IP address, although you may choose to disclose them.  

To enter the gift card raffle, please enter your contact info at the end of the survey. We will keep this information separate from your responses.

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* 1. What is your gender?

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* 3. Are you of Hispanic, Latino, or Spanish origin?

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* 4. What is your race? Mark one or more boxes.

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* 5. Are any of these true for you?

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* 6. Primary language spoken at home:

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* 7. Location:

5% of survey complete.