• English
  • Español
  • Oromoo
  • Soomaali
  • Tagalog
  • Tiếng Việt
  • Русский
  • العربية
  • ትግርኛ
  • አማርኛ
  • ខ្មែរ
  • 中文（简体）
  • 中文（繁體）
  • 한국어
Privacy Notice:
Information provided in this survey is considered a public record and may be subject to public disclosure. For more information, see the Public Records Act, RCW Chapter 42.56. To learn more about how we manage your information, see our Privacy Statement. 
 
Please complete the short questionnaire below. Before completing the form, please check if you live in an eligible property. If you need a replacement card, please call or text (206)256-6722 or email ORCAOpportunity@seattle.gov. 

Question Title

* 1. What is your first name?

Question Title

* 2. What is your last name?

Question Title

* 3. What is your t-code? (It's on your rent statement)

Question Title

* 4. What is your address?

Question Title

* 5. Are you currently a participant in the SHA Transit Pass program? (ie Do you currently a receive a free ORCA card from SHA?)

Question Title

* 6. What Seattle Housing Authority property do you live in?

Question Title

* 7. What is your date of birth?

Date

Question Title

* 8. What is your race or ethnicity? Select all that apply.

Question Title

* 9. What is your preferred language for communication?

Question Title

* 10. How did you hear about this program? Select all that apply

Question Title

* 11. What is the best way for us to contact you? Please note: your contact information will not be shared without your permission. We will use this to confirm eligibility, let you know about updates or changes to the program, or send a future survey about how the program is working.

T