1.

Welcome to the California Council of the Blind 2017 Demographics Survey. As a democratic organization, every voice matters and will be listened to. We want to hear from you. You  can make a difference in the future of the CCB!
 
Please share no more than 30 minutes of your time to complete the CCB Demographic Profile Survey.
 
The information that you share with us will help us to more fully understand and describe our membership, help to make a more comprehensive case for support to potential funders and investors and  help us determine the path to our future .
 
All responses will be strictly anonymous unless you specifically provide your information for follow-up. In that case, your contact information will only be shared with the person assigned to do follow-up.  Survey responses will not be shared.  No personally identifiable information will be shared with anyone except in the case noted above.
 
Overall survey results will be made available to the general membership after the completion of the open survey time period and the completion of the data analysis.
 
Thank you in advance for your open, honest and complete responses to the survey. It could be the most important 30 minutes that you spend today.
 
We appreciate all that you do in the name of the CCB and our grateful for your ongoing support.

Please choose one of the two ways to complete the survey:

1)      Online through Survey Monkey
 
Or

2)      Over the telephone. Leave a message with the CCB office at 800-221-6359  with your name and telephone number. A CCB representative will call you back to ask the survey questions over the telephone.
All comment boxes have 100 Characters limit.
Please press okay button after each question and Done at the end of the survey.

* 1. Are you a CCB Member?

* 2. Please check all of the CCB Chapters and affiliates of which you are a member

* 3. How many hours on average a month, do you spend on meetings, committees, and the work of the CCB?

* 4. How many hours per month do you spend on CCB related social activities?

* 5. What does it mean to you to be a member of the CCB?
Please explain

* 6. What have you gained from being a member of the CCB?
Please explain

* 7. Please check all of the services that you have received from the CCB

* 8. As a CCB Member, what skills have you developed? Check all that apply

* 9. What knowledge, experience, skills and abilities do you have that you would be willing to share with other CCB Members?
Please explain

* 10. How confident are you in making referrals or providing mentor-ship in the following areas for other CCB Members?

  Not Cofident at all Limited confidence based on situations that I have personally overcome Somewhat confident Very confident Extremely confident (I could teach these topics)
Referrals to appropriate medical treatment
Training in specific skills to manage blindness such as, cane travel; braille, non-visual ways of managing household tasks, etc.
Participation in a community with other people living well with blindness or low vision

* 11. Are you active in other community organizations outside of the CCB and ACB? If so, how many?

* 13. What is your highest level of education to date?

* 14. If you are a current student, please check the box that best describes your current educational pursuit.

* 15. Are you currently a student?

* 16. If employed, what classification do you most closely fit?

* 17. If, employed, check your employment status

* 18. If employed, what industry do you currently work in?

* 19. If employed, check how many years you have been employed?

* 20. Please check what you believe are your barriers to employment?

* 21. What is your current employment status?

* 22. If employed, do you feel that being blind or having low vision has led to you being underemployed and/or has resulted in you being denied opportunities for advancement?

* 23. What racial, ethnic and cultural groups do you identify most closely with? Please check all that apply.

* 24. What age range do you fall into?

* 25. What Gender do you most closely identify as?

* 26. What sexual orientation do you most closely identify with?

* 27. Please comment on your vision status? Are you:

* 28. What is your annual income level?

* 29. Please take a minute to comment on what services you would like to see the CCB offer in the future, such as: Assistance with healthcare forms and healthcare provider; Assistance with learning assistive technology; Assistance with all things IRS and SSA; Assistance with finding community resources,  and anything else that you feel is important for the CCB to offer.
Please comment below

* 30. What communication avenues do you use most to stay informed about the CCB? Please Check all that apply.

* 31. If you would like to become involved or more involved in the CCB, please list your contact information below including your name, address, email address and phone number.
Please comment below

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