On The Move Participant Needs

Please tell us your needs related to the Coronavirus (COVID-19)

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* 1. In which county do you live?

Napa County

Sonoma County

Solano County

San Francisco County

Alameda County

Contra Costa County

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* 2. What is your age range?

Under 18

18 - 26

27 - 50

51 - 64

65+

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* 3. Please let us know what your household currently needs (check all that apply)

Additional food supplies

Information on how to stay healthy

Information on what to do if I/ someone in my family is sick

I am a senior and I need help gathering supplies and things I need

I know a senior that needs help gathering supplies and things they need

Information on available childcare options

Money to pay my rent

Money to pay my utilities

Information on shelter options

Access to services to support my emotional health

Access to the Internet

Computer to do work/school work from home

Job training

Understanding government benefits

Translation Services

I have everything I need

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* 4. Do you have students in the home that are expected to engage in remote learning for school?

Yes

Optional - what age(s) are the students?

On The Move Participant Needs

Question Title

* 1. In which county do you live?

Question Title

* 2. What is your age range?

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* 3. Please let us know what your household currently needs (check all that apply)

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* 4. Do you have students in the home that are expected to engage in remote learning for school?

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* 5. Is there anything else you would like us to know?