Springfield No One Leaves/Nadie Se Mude - Housing/Community Issues Assessment Survey
This summer, Springfield No One Leaves is surveying hundreds of residents throughout the city to learn about and identify the issues that our communities are most concerned about and to plan organizing campaigns to increase the voice and power of our community and fight to win victories that address these issues. Please take a minute to fill out this survey:
* Required
What neighborhood do you live in?
*
Your answer
Are you
A Renter
A Homeowner
Homeless
Clear selection
How much do you pay monthly for your housing?
Your answer
How much do you pay monthly for your utilities?
Your answer
What is your monthly income?
Your answer
On a scale of 1 to 5, how concerned are you about:
The cost of Rent/Mortgage
Not concerned
1
2
3
4
5
Very concerned
Clear selection
Foreclosure
Not concerned
1
2
3
4
5
Very concerned
Clear selection
Threat of Eviction or Displacement
Not concerned
1
2
3
4
5
Very concerned
Clear selection
Homelessness
Not concerned
1
2
3
4
5
Very concerned
Clear selection
Bad conditions in your home
Not concerned
1
2
3
4
5
Very concerned
Clear selection
Vacant Land/Buildings
Not concerned
1
2
3
4
5
Very concerned
Clear selection
Lack of Affordable Housing
Not concerned
1
2
3
4
5
Very concerned
Clear selection
Lack of Employment
Not concerned
1
2
3
4
5
Very concerned
Clear selection
Neighborhood/Home Safety
Not concerned
1
2
3
4
5
Very concerned
Clear selection
Safe Community Space
Not concerned
1
2
3
4
5
Very concerned
Clear selection
Are you currently facing:
Check all applicable
A rent or mortgage increase?
Bad Conditions?
Foreclosure?
Eviction?
Unemployment/Underemployment?
Homelessness?
Please give us some details:
Your answer
Do you know your legal housing rights?
Not at all
Some of them
Most of them
Every last one
What other issues in your community are you most concerned about?
Your answer
If you could change anything in your community what would it be?
Your answer
If you had the power to decide what type of development happens in your neighborhood, what would you do? (i.e. parks, school affordable housing, etc...)
Your answer
Race/Ethnicity:
Your answer
Gender:
Your answer
Age:
Your answer
Citizenship:
Your answer
Sexuality:
Your answer
City you live in:
Your answer
City/Town/Country of Origin:
Your answer
--OPTIONAL--
Name:
Your answer
Phone Number:
Your answer
Email
Your answer
Address:
Your answer
Would you be interested in getting involved with Springfield No One Leaves/learning more?
*
YES
NO
Would you be willing to participate in a focus group discussion on housing and income issues?
*
YES
NO
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