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MOD Constituent Survey
1.
What is your age?
Under 25
25 - 34
35 - 44
45 - 54
55 - 64
65 or older
2.
What city or town do you live in?
3.
What information would you be most interested in receiving from MOD? Select all that apply:
Information about my legal rights
Information about my legal obligations
Upcoming trainings and events
Resources for state employees
Information on how I can make my community more accessible
Other (please specify)
4.
Which of these best describes you? Select all that apply:
I am a person with a disability
I am the parent of a child with disability
I am a state employee
I am a municipal employee
I work for a non-governmental disability organization/nonprofit
I am a business owner
I am a housing provider (landlord)
Other (please specify)
5.
How did you first hear about MOD?
Internet search
Training or event
Social media post
Word of mouth
Other (please specify)
6.
What social media platforms do you visit most frequently? Select up to 3:
Facebook
Twitter
LinkedIn
Instagram
YouTube
TikTok
7.
If you would be open to a phone call to give more in-depth feedback, please provide your email address: