Please take a moment to fill out this survey, which will help improve our organization and services at Proteus, Inc. This survey will help Proteus understand the needs of your community and design programs that will best serve you. When completed, Proteus staff will collect the survey. Thank you in advance for your time.

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* 1. Which of the following type(s) of organization(s)
do you represent (check all that apply)?

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* 2. Which of the following best describes you?

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* 3. Race/Ethnicity (Check all that apply):

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* 4. Age:

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* 5. Gender:

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* 6. What county do you live in?

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* 7. What City/town do you live in?

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* 8. Marital Status:

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* 9. Number of people in your home:

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* 10. How many under 18?

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* 11. Total Annual household income:

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

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* 13. If unemployed, what is the reason for not
working?

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* 14. What is the highest level of education you have
completed?

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* 15. Which of the following best describes your
housing status?

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* 16. Which of the following best describes your
household composition:

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* 17. Have you received public benefits in the last 2
years (check all that apply)?

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* 18. Has anyone in your household received services
from Proteus, Inc. within the last 2 years (check
all that apply)?

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* 19. Which of the following barriers prevent you
from seeking assistance for your basic needs
(check all that apply)?

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* 20. Which of the following do you have access to in
your home (check all that apply)?

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* 21. What are the greatest issues and concerns in your community? Please choose your top three.

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* 22. What programs are most needed to improve the LIVABLITY of your community? Please choose your top three in each category.

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* 23. What programs are most needed for YOUTH in your community? Please choose your top three.

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* 24. What programs are most needed for the FAMILIES in your community?

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* 25. What programs or services have you used at Proteus, Inc. in the past?

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* 26. If you used Proteus, Inc. services in the past, were you satisfied? Why or why not?

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* 27. If you used Proteus, Inc. services in the past, did you face any barriers? Please explain.

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* 28. What programs and services do you think Proteus should continue to offer?

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* 29. What programs and services do you think Proteus should start offering?

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* 30. What is the best way for you to learn about current or new Proteus, Inc. services?

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* 31. Do you think Proteus meets the needs of the communities it serves? Why or why not?

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* 32. What do you think Proteus, Inc. does well?

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* 33. What do you think Proteus, Inc. can improve upon?

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* 34. What is the primary language in which you read/write?

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* 35. Do you wish to receive information on any Proteus program? If so, please provide the following information:

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