Which best describes you and your relationship with TCCA

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* 1. Which best describes you and your relationship with TCCA

Are you male or female

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* 2. Are you male or female

Are you White, African-American, Hispanic, American Indian, or Alaskan Native, Asian, Native Hawaiian, or other Pacific Islander, or other race

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* 3. Are you White, African-American, Hispanic, American Indian, or Alaskan Native, Asian, Native Hawaiian, or other Pacific Islander, or other race

In what zip code is your home located?

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* 4. In what zip code is your home located?

What is your age?

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* 5. What is your age?

Which of the following best describes your household type?

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* 6. Which of the following best describes your household type?

In which City/Community do you currently work?

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* 7. In which City/Community do you currently work?

How many people, by age, currently live in your household?

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* 8. How many people, by age, currently live in your household?

Which of he following describes your current sources of household income? (check all that apply)

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* 9. Which of he following describes your current sources of household income? (check all that apply)

Which of the following categories best describes your employment status?

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* 10. Which of the following categories best describes your employment status?

Considering the Life Area of HOUSING. Which if the following statements describes your situation best?

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* 11. Considering the Life Area of HOUSING. Which if the following statements describes your situation best?

Considering the Life area of SAFETY. Which of the following statements describes your situation best?

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* 12. Considering the Life area of SAFETY. Which of the following statements describes your situation best?

Considering the Life Area of FOOD. Which of the following statements describes your situation best?

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* 13. Considering the Life Area of FOOD. Which of the following statements describes your situation best?

Considering the Life Area of PHYSICAL HEALTH. Which of the following statements describes your situation best?

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* 14. Considering the Life Area of PHYSICAL HEALTH. Which of the following statements describes your situation best?

Considering the Life Area of HEALTHCARE. Which of the following
statements describes your situation best?

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* 15. Considering the Life Area of HEALTHCARE. Which of the following
statements describes your situation best?

Considering the Life Area if INCOME. Which of the following statements describes your situation best?

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* 16. Considering the Life Area if INCOME. Which of the following statements describes your situation best?

Considering the Life Area of EMPLOYMENT. Which of the following
statements describes your situation best?

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* 17. Considering the Life Area of EMPLOYMENT. Which of the following
statements describes your situation best?

Considering the Life Area of SUPPORT NETWORK. Which of the 
following statements best describes your situation best?

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* 18. Considering the Life Area of SUPPORT NETWORK. Which of the 
following statements best describes your situation best?

Considering the Life Area of MOBILITY. Which of the following
statements describes your situation best?

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* 19. Considering the Life Area of MOBILITY. Which of the following
statements describes your situation best?

Considering the Life Area of LIFE SKILLS. Which of the following
statements describes your situation best?

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* 20. Considering the Life Area of LIFE SKILLS. Which of the following
statements describes your situation best?

Considering the Life Area of CHILD CARE. Which of the
following statements best describes your situation best?

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* 21. Considering the Life Area of CHILD CARE. Which of the
following statements best describes your situation best?

Considering the Life Area of CHILDREN'S EDUCATION. Which of the
following statements describes your situation best?

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* 22. Considering the Life Area of CHILDREN'S EDUCATION. Which of the
following statements describes your situation best?

Considering the Life Area of PARENTING. Which of the following
statements describes your situation best?

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* 23. Considering the Life Area of PARENTING. Which of the following
statements describes your situation best?

Considering the Life Area of LEGAL. Which of the following statements
best describes your situation best.

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* 24. Considering the Life Area of LEGAL. Which of the following statements
best describes your situation best.

Considering the Life Area of MENTAL HEALTH. Which of the 
following statements describes your situation best?

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* 25. Considering the Life Area of MENTAL HEALTH. Which of the 
following statements describes your situation best?

Considering the Life Area of SUBSTANCE ABUSE. Which of 
the following statements describes your situation best?

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* 26. Considering the Life Area of SUBSTANCE ABUSE. Which of 
the following statements describes your situation best?

Of the selections provided below, please choose all of the 
answer choices you believe are the services that Tri-County Community Action Agency currently offer.

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* 27. Of the selections provided below, please choose all of the 
answer choices you believe are the services that Tri-County Community Action Agency currently offer.

What additional services do you feel TCCA, or other
organizations, should provide to create the optimal level of
assistance for you or others you may know who have needs
in your community. Please list as many items as you would
like.

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* 28. What additional services do you feel TCCA, or other
organizations, should provide to create the optimal level of
assistance for you or others you may know who have needs
in your community. Please list as many items as you would
like.

Comments.

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* 29. Comments.

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