Section 1:  Family/Neighborhood Data
Data

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* 1. Data

Current housing:

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* 3. Current housing:

How long have you lived in East Hartford?

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* 4. How long have you lived in East Hartford?

How many people live in your household?

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* 5. How many people live in your household?

Do you have a driver's license?

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* 6. Do you have a driver's license?

Do you have other family (parents, siblings) that lives in East Hartford?

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* 7. Do you have other family (parents, siblings) that lives in East Hartford?

How old are you?

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* 9. How old are you?

Primary Language Spoken at Home:

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* 10. Primary Language Spoken at Home:

How would you rate your spoken English?

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* 11. How would you rate your spoken English?

How would you rate your written English?

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* 12. How would you rate your written English?

How would you rate your reading in English?

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* 13. How would you rate your reading in English?

Connection to the neighborhood.  Do you know your neighbors (help each other out, do things together, work on any community issues)?
If no, why not?

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* 14. Connection to the neighborhood.  Do you know your neighbors (help each other out, do things together, work on any community issues)?
If no, why not?

Explain what types of things you think brings neighbors together?

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* 15. Explain what types of things you think brings neighbors together?

If you could choose one way to physically improve your neighborhood, what would it be (for example:  install speed bump, closer bus stop, trash containers, a new playground)?

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* 16. If you could choose one way to physically improve your neighborhood, what would it be (for example:  install speed bump, closer bus stop, trash containers, a new playground)?

Do you participate in any community groups? If yes, What?

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* 17. Do you participate in any community groups? If yes, What?

Would you be willing to participate in a group like a Neighborhood Association?  (neighbors coming together to discuss and develop solutions around issues of neighborhood improvement)

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* 18. Would you be willing to participate in a group like a Neighborhood Association?  (neighbors coming together to discuss and develop solutions around issues of neighborhood improvement)

Section 2:  Education and Employment
How far did you go in school?

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* 19. How far did you go in school?

Do you have any other credentials/certificates/training skills?"

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* 20. Do you have any other credentials/certificates/training skills?"

If yes, what field(s) are those credentials/certificates/training/skills in (for example: customer service, packing, warehouse, cooking, cosmetology)?

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* 21. If yes, what field(s) are those credentials/certificates/training/skills in (for example: customer service, packing, warehouse, cooking, cosmetology)?

Are you currently employed? 

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* 22. Are you currently employed? 

If yes,

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* 23. If yes,

If NO:

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* 24. If NO:

If you had a choice, what kind of career would you want?

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* 25. If you had a choice, what kind of career would you want?

What are some of the factors keeping you from the job you want?

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* 26. What are some of the factors keeping you from the job you want?

Could you dedicate several months to a training program in a career path below? If no, why not?

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* 27. Could you dedicate several months to a training program in a career path below? If no, why not?

These are some career paths and industries that have local training programs and actual employment opportunities - would you be interested in any of these? If yes, please check all that apply.

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* 28. These are some career paths and industries that have local training programs and actual employment opportunities - would you be interested in any of these? If yes, please check all that apply.

Would you be interested in an adult education class for improved English skills?

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* 29. Would you be interested in an adult education class for improved English skills?

Would you be interested in an adult education class for improved Literacy skills?

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* 30. Would you be interested in an adult education class for improved Literacy skills?

Would you be interested in career assessment services to evaluate job skills, readiness and opportunities?

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* 31. Would you be interested in career assessment services to evaluate job skills, readiness and opportunities?

Do or would you require childcare in order to work?

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* 32. Do or would you require childcare in order to work?

Have you ever had trouble getting to work on time? If yes, why?

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* 33. Have you ever had trouble getting to work on time? If yes, why?

If you require childcare to work, what are your childcare options?

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* 34. If you require childcare to work, what are your childcare options?

How do you get to work:

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* 35. How do you get to work:

Does your family have enough to make ends meet or are you struggling to pay bills?

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* 36. Does your family have enough to make ends meet or are you struggling to pay bills?

Do you think your neighbors have enough to make ends meet, or are they struggling to pay bills?

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* 37. Do you think your neighbors have enough to make ends meet, or are they struggling to pay bills?

Section 3:  Youth Programming
Please provide the following:

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* 38. Please provide the following:

Is getting to school on time an issue for your kids or family? If so, why?

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* 39. Is getting to school on time an issue for your kids or family? If so, why?

Do they attend any community based programs for youth?  Which program?

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* 40. Do they attend any community based programs for youth?  Which program?

What type of resource or program would you like to see in this community that is currently not offered?

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* 41. What type of resource or program would you like to see in this community that is currently not offered?

Section 5:  Follow up
Are you interested in what happens with Working Cities, can we follow up with you?

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* 42. Are you interested in what happens with Working Cities, can we follow up with you?

How do you prefer to be contacted? 
Please Choose all that apply

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* 43. How do you prefer to be contacted? 
Please Choose all that apply

Do you have internet access at home or on your phone?

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* 44. Do you have internet access at home or on your phone?

Do you use social media?

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* 45. Do you use social media?

Would you be willing to attend a community meeting for more info and get involved?

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* 46. Would you be willing to attend a community meeting for more info and get involved?

Are you a Summerfield resident?

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* 47. Are you a Summerfield resident?

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