Citizenship Survey
This survey is completely anonymous, and is merely being used to find out if a citizenship class would be helpful in Elkhart County.
Are you or anyone you know interested in becoming a United States citizen?
Yes
No
If the answer is yes… Where are you/they in the citizenship process?
Have not started
Just started
In the middle
Far along
Would you/they be interested in citizenship classes if they were offered for free?
Yes
No
Do you/they speak English well? Rate your/their ability on a scale from 1-10. (1 being poor and 10 being fluent)
1
2
3
4
5
6
7
8
9
10
If offered, what days of the week work well for you to attend classes? (Select all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
If offered, what times work well for you to attend classes?
Do you/they have a consistent form of transportation?
Yes
No
Which location(s) would be the most convenient for you?
Northridge High School- 56779 Northridge Dr., Middlebury
Elkhart County Historical Museum- 304 W. Vistula St., Bristol
Elkhart Public Library- Downtown branch-300 S 2nd St., Elkhart
Elkhart County Administration Building- 117 N 2nd St., Goshen
If you would like to receive more information, put your email or contact information below.
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This form was created inside of Middlebury Community Schools.
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