2021 Community Needs Assessment of Older Adults Demographic Information Question Title * 1. In which Northwest Indiana County do you live? Lake County Porter County Newton County Jasper County Pulaski County Starke County Other (please specify) OK Question Title * 2. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305) OK Question Title * 3. Are you a person living with a disability? Yes No OK Question Title * 4. Gender: How do you identify? Man Non-binary Woman Prefer to self-describe, below Self-describe: OK Question Title * 5. Do you identify as LBGTQ+? Yes No OK Question Title * 6. What is your household monthly income? Less than $1000 per month $1001 - $1500 per month $1501 - $2000 per month $2001 - $2500 per month $2501 - $3000 per month Greater than $3000 per month OK Question Title * 7. What is the highest level of education you have completed? Did not attend school 1st grade 2nd grade 3rd grade 4th grade 5th grade 6th grade 7th grade 8th grade 9th grade 10th grade 11th grade Graduated from high school 1 year of college 2 years of college 3 years of college Graduated from college Some graduate school Completed graduate school OK Question Title * 8. What is your race or ethnicity? Asian Black or African American Hispanic or Latino Middle Eastern or North African Multiracial or Multiethnic Native American or Alaska Native Native Hawaiian or other Pacific Islander White Another race or ethnicity, please describe below Self-describe below: OK NEXT