Chapel Hill and Orange County, North Carolina are preparing their CDBG and HOME Programs Five Year Consolidated Plan and Annual Action Plan. As part of the planning process, the Municipalities are conducting a survey to identify residents' needs in the community, ideas on how the residents would like to see funds under the CDBG and HOME Programs spent. In order for the Municipalities to address the housing needs of its residents, we request your assistance. Please take a few minutes and complete this confidential questionnaire to the best of your ability. If you are unsure of an answer, or the question does not apply to you, please feel free to skip that question. Thank you for your assistance in helping us to identify residents' needs and Fair Housing issues in the area.

What is your street name and ZIP Code where you live in Orange County

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* 1. What is your street name and ZIP Code where you live in Orange County

Gender

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* 2. Gender

Race/Ethnicity (choose all that apply)

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* 3. Race/Ethnicity (choose all that apply)

Age

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* 4. Age

Number of persons living in your household?

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* 5. Number of persons living in your household?

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