Toxic Free NC's 2017 End of Year Survey
We strive to reflect the needs of our supporters and communities in which we work across the state. We appreciate your time and effort in filling out this survey. Your input will help guide our future work in alignment with all of you toward a North Carolina where human and environmental health are valued by all. Your responses will be confidential and used to ensure that our work is informed by needs and concerns identified by the community at large.

By participating, you will be entered into a drawing for a growing list of prizes including:

$50 gift certificate to LUSH
$89 gift certificate to Om Spa in Charlotte
A behavioral assessment from Brain Balance Achievement Center in Cary, Chapel Hill, Raleigh, Pineville, or Cornelius ($300 value)!

Submit your answers by January 15th for your chance to win! Winners will be announced in our January newsletter!

Name *
Your answer
Contact information *
Your answer
How did you hear about Toxic Free NC?
Do you live in North Carolina
If no, or part time, to previous question, then where do you live?
Your answer
Would you be interested in volunteering for Toxic Free NC?
If yes to previous question, please provide your e-mail below.
Your answer
How do you prefer to receive information? (mark all that apply)
Which of these social change strategies seem effective to you? (mark all that apply)
Would you be interested in participating any of the following activities? (mark all that apply)
How are you willing to support social change? (mark all that apply)
How do you promote human and environmental health in your community? (recycling, water quality, composting, pesticide free landscape/garden...etc)
Your answer
What work motivates you to support Toxic Free NC? (mark all that apply)
What issues concerning toxics do you feel more attention needs to be focused on in North Carolina? (mark all that apply)
What part(s) of NC do you think increased attention on human and environmental impacts of toxics should be prioritized?
How would you rate your level of concern for the impact of environmental pollutants in your life?
Demographic Questions
The following questions will help us to gain a better understanding of the social/economic demographics of our constituents and helps us gauge where we need to strengthen our constituent base. We appreciate your responses to these optional questions if you so chose to provide them.
How would you describe yourself? (Choose all that apply)
What is your age?
Your answer
What is your average household income?
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