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Short Food Insecurity Survey
*
1.
Are you a University student? If so, please specify your year in college
(Required.)
Freshman
Sophomore
Junior
Senior
Graduate Student
Non University student
2.
Indicate your level of agreement to the following statements:
"I struggle to afford groceries during a typical week."
Strongly agree
Agree
Somewhat agree
Neither agree nor disagree
Somewhat disagree
Disagree
Strongly disagree
3.
“I feel like I would benefit from additional support for food costs.”
Strongly agree
Agree
Somewhat agree
Neither agree nor disagree
Somewhat disagree
Disagree
Strongly disagree
4.
“I am aware of what SNAP (Supplemental Nutrition Assistance Program) is”
Strongly agree
Agree
Somewhat agree
Neither agree nor disagree
Somewhat disagree
Disagree
Strongly disagree
5.
“I am aware of Mountain Root’s weekly backyard harvest”
Yes
No
6.
During the last two weeks, how frequently did you worry about affording groceries:
Never
Every day
A few times a day
About once a week
7.
Would you like to have someone follow up with you with food support resources? If so, please provide contact information. Email/phone #
This information will be shared with Mountain Roots and the Food Pantry Staff for assistance/follow up.
Current Progress,
0 of 7 answered