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SHORE UP! Inc. Participant Survey
1.
Thank you for taking a few minutes to answer this survey. We appreciate it! First, could you tell us in which county you reside?
Wicomico
Somerset
Worcester
Dorchester
Talbot
Kent
Queen Anne's
Other (please specify)
2.
And what program's services did you utilize when you visited SHORE UP?
Head Start or Early Head Start
Energy Assistance
Home Weatherization
GED Preparation
Skills Training
Child Development Associate Program
Adult Day Services
Housing Counseling
Income Tax Preparation
Foster Grandparents
Other (please specify)
3.
How did you first hear of SHORE UP and our programs?
Advertisement
Social Media
A friend's recommendation
Referral from another organization/agency
Other (please specify)
4.
How many years have you been utilizing SHORE UP's services?
Less than 1 year
1-3 years
3-5 years
5-10 years
more than 10 years
5.
Were you treated with respect by the SHORE UP staff you encountered?
Yes
No
Comments:
6.
Do you have any needs that were not addressed on this visit? (check all that apply)
Help caring for an elderly or disabled relative
Child care for a preschooler (5 or younger, not in school)
Help making my home more energy efficient
Help paying my electric or heating bills
Help obtaining a GED diploma
Helping learning new skills for employment purposes
I would like to become a homeowner but I don't know if I can afford it
I would like to work in child care but I don't know how to start
I need help with preparing my taxes.
Other (please specify)
7.
Do you have any suggestions on how SHORE UP can improve?
Yes
No
If yes, please specify:
8.
Overall, how would you rate your level of satisfaction with SHORE UP?
Very satisfied
Satisfied
Neither Satisfied nor Dissatisfied
Dissatisfied
Very Dissatisfied
9.
Would you recommend SHORE UP to a friend?
Yes
No
Comments:
10.
Would you like someone from SHORE UP to contact you about your experience?
Yes
No
If yes, please include name and phone number or email address here:
11.
Finally, please provide us with some demographical data for statistical purposes only
Your Gender:
Your Race:
Are You Hispanic?
Your Age:
