Counseling Survey

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Anyone who completes this survey and provides their contact information will be entered into a drawing to win a $75 Visa Gift Card

Question Title

* 1. Are you a male or female head of household?

Male

Female

Question Title

* 2. Please specify your racial composition.

African American

White

Asian

American Indian or Alaskan Native

Native Hawaiian or Other Pacific Islander

Other

Question Title

* 3. Please Specify your Ethnicity Composition

Hispanic or Latino

Non Hispanic or Latino

Question Title

* 4. Please choose the city you reside in.

Question Title

* 5. Have you ever contacted Fair Housing Resource Center for Assistance?

Yes

No

Question Title

* 6. Are you a renter or a mortgagor?

Renter

Mortgagor

17% of survey complete.