Survey Questionnaire

To help fund some of the infrastructure projects in the city, the City of Leonard is applying for grant funds from the Texas Community Development Block Grant, and they require a response from every home in town regarding family income.  Please read the questions below and answer truthfully.  Thank you for your participation in helping further the city's repairs and enhancements.

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* 1. Name

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* 2. Street Address

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* 3. Including yourself, how many people usually live in the home?

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* 4. Including yourself, how many people in your family usually live in this home?

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* 5. Do any other families live in this home?  *If so, please submit a separate questionnaire for each family that lives in this unit.

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* 6. Family size

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* 7. Family Income - Please specify to the nearest ten dollars, your family's yearly income.  This information is confidential and will only be shared with the grant administrators.

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* 8. Race

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