SENIOR SNAP ACCESS SURVEY

Senior SNAP Access Survey

Second Harvest Food Bank of Northeast Tennessee, along with Feeding America, needs input from seniors age 60 and over about why they are not applying for SNAP benefits. Please take a few moments to give your input by answering these True or False questions below.

Question Title

* 1. I DO use the internet for information on senior programs and services.

True

False

Question Title

* 2. I would not apply online, I need someone to send me an application and assist me in applying.

True

False

Question Title

* 3. I DO NOT use the internet for information on senior programs and services.

True

False

Question Title

* 4. I used the pre-screen tool, but it’s hard to understand.

True

False

Question Title

* 5. I can apply online and don’t need assistance.

True

False

Question Title

* 6. It is hard for me to get to the DHS office – I need someone to take me.

True

False

Question Title

* 7. I don’t have the necessary papers to apply – I need someone to help me get my paperwork.

True

False

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* 8. I have received benefits in the past, but the amount is too low and not worth the trouble to apply.

True

False

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* 9. My income qualifies, but I think my assets are too great.

True

False

Question Title

* 10. People living in my house are not related to me.

True

False

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* 11. I always eat out so it doesn’t help me.

True

False

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* 12. I may qualify, but if I get SNAP it takes it away from others who need it.

True

False

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* 13. My grandchildren (or great grandchildren) live with me, but I don’t have custody of them. Therefore, I don’t count them in my household count.

True

False

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* 14. My partner and I are living together, but not married; both our incomes have to be counted.

True

False

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* 15. I could probably qualify, but don’t want to use SNAP. I would be embarrassed to receive government funded assistance.

True

False

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* 16. I may qualify, but SNAP is just for poor people.

True

False

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* 17. I don’t want to be seen using the card at the grocery store.

True

False

Question Title

* 18. Please enter your information. It is to be used for survey purposes only.

Name

Age

Phone Number

Zip Code

County

Number of People in Household

Work Status (FT, PT, Unemployed, Retired, etc.)

Race

Ethnicity

Referral Source

SENIOR SNAP ACCESS SURVEY