Community Perception Survey

INDYAlive!, formerly known as 25 & Alive, has a new mission: to care for, support and inspire our whole community through every stage of life.

To determine how INDYAlive! will implement this new mission; we need your input! Please take a few minutes to let us know how we can make the biggest impact in our community.

Question Title

* 1. What do you believe are the four (4) areas most impacting our community where INDYAlive! could make a difference? (Please check up to four (4) boxes).

Aging

Aging in Place (staying in my own home as I get older)

Awareness & Acceptance of Diversity (ethnic, gender identity, racial, sexual orientation, socioeconomic status)

Distracted Driving

Education

Food Insecurity

Healthy Dating/Romantic Relationships

Mental Health

Obesity

Peer Pressure

Public Safety

Social Inequities

Social Isolation

Social Media

Substance Use

Violence

Workforce Development

Other (please specify)

Question Title

* 2. Please tell us with which groups you identify (Check all that apply).

Student (K-12)

College Student or Graduate

Young Adult (18-25)

Adult (26-59)

Parent

Senior (60+)

City of Independence Employee

School/Personnel Administrator

Business Employee

Business Owner

Church/Faith-Based Professional

Other (please specify)

Question Title

* 3. Would you be interested in contributing to INDYAlive! as part of Community Committee? If yes, please share your contact information below in question 4.

Yes

Question Title

* 4. Please share your contact information if you would like to be entered to win an Amazon gift card. If you prefer that your answers remain anonymous, please do not complete this section.

Name

City/Town

Email Address

Phone Number