Community Needs & Impediments to Fair Housing Survey- Pike County, Ohio

Demographic Questions

Questions 1-10 are the general demographic questions. These questions are asked to help us generate survey results based on demographic characteristics of the respondents. This survey is Anonymous.

Question Title

1. What is your gender?

Female

Male

Other (specify)

Question Title

2. What is your 5-digit zipcode?

Question Title

3. What is your racial or ethnic identity? (Select all that apply.)

African-American/Black

East Asian

Hispanic/Latinx

Middle Eastern

American Indian/Alaskan Native

Pacific Islander

South Asian

Southeast Asian

White

Other (please specify)

Question Title

4. What is your age?

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

Question Title

5. What is your total annual household income before taxes in the most recent tax year?

Under $15,000

Between $15,000 and $29,999

Between $30,000 and $49,999

Between $50,000 and $74,999

Between $75,000 and $99,999

Between $100,000 and $150,000

Over $150,000

Question Title

6. Which of the following best describes your current relationship status?

Married

Widowed

Divorced

Separated

Cohabiting with a significant other or in a domestic partnership

Single, never married

Prefer not to answer

Question Title

7. Besides yourself, do you have any of the following people living in your household?

Persons under 18

Persons 18-30

Persons 31-60

Persons 61+

Question Title

8. How many people live in your household, including yourself?

Question Title

9. Does any disability, handicap, chronic disease keep you and/or family member from participating in work, school, housework or other activities?

Yes

Question Title

10. Which of the following categories best describes your employment status?

Employed, working full-time

Employed, working part-time

Not employed, looking for work

Not employed, NOT looking for work

Retired

Disabled, not able to work

Community Needs & Impediments to Fair Housing Survey- Pike County, Ohio

Demographic Questions

Question Title

* 1. What is your gender?

Question Title

* 2. What is your 5-digit zipcode?

Question Title

* 3. What is your racial or ethnic identity? (Select all that apply.)

Question Title

* 4. What is your age?

Question Title

* 5. What is your total annual household income before taxes in the most recent tax year?

Question Title

* 6. Which of the following best describes your current relationship status?

Question Title

* 7. Besides yourself, do you have any of the following people living in your household?

Question Title

* 8. How many people live in your household, including yourself?

Question Title

* 9. Does any disability, handicap, chronic disease keep you and/or family member from participating in work, school, housework or other activities?

Question Title

* 10. Which of the following categories best describes your employment status?

1. What is your gender?

2. What is your 5-digit zipcode?

3. What is your racial or ethnic identity? (Select all that apply.)

4. What is your age?

5. What is your total annual household income before taxes in the most recent tax year?

6. Which of the following best describes your current relationship status?

7. Besides yourself, do you have any of the following people living in your household?

8. How many people live in your household, including yourself?

9. Does any disability, handicap, chronic disease keep you and/or family member from participating in work, school, housework or other activities?

10. Which of the following categories best describes your employment status?