This survey is designed to help us better understand the challenges that keep people from moving out of poverty.  Thank you for taking the time to answer the following questions.  Your responses will be used to develop services that reduce poverty. 

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* 1. How many people live in your household?

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* 2. What is your gender?

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* 3. What is your age?

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* 4. Where do you live?

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* 5. What is your highest level of education achieved?

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* 6. What is your estimated annual household income?

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* 7. How many adults (18 and over) in your home are employed?

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* 8. How many adults (18 and over) in your home are looking for work?

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* 9. Assuming jobs are available, what is the top issue making it difficult for people to gain employment?  (Please select only one.)

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* 10. What is your housing status?

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* 11. Which of the following housing issues apply to your household? (Please check all that apply.)

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* 12. Which of the following transportation issues apply to your household? (Please check all that apply.)

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* 13. Do any of the adults (18 and over) in your household need help with the following? (Please check all that apply.)

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* 14. Please list any other barriers preventing people from moving out of poverty or ideas you may have for reducing poverty:

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