Housing Needs Assessment
Purpose: The Tribal Council is conducting this survey to obtain information necessary to apply for an Indian Community Development Block Grant for new and refurbished housing. It important to the success of the application that you complete the following survey.

Confidentiality: Your responses will be confidential, and no one except from the research team will have access to identifiable information.

Obligation: You are not obligated to answer any questions if you do not wish to do so, however, unanswered question may skew the research. By answering these questions you are voluntarily agreeing that these results may be used by the Chilkat Indian Village.


EACH PERSON WHO COMPLETES THE SURVEY WILL BE ENTERED FOR A DRAWING FOR A $100.00 GIFT CARD.

How many economically separate families live in your household? (If more than one, each economically separate family must fill out a separate application).
Household Structures
THIS SECTION IS FOR KLUKWAN RESIDENTS ONLY. IF YOU ARE FROM HAINES OR JUNEAU, PLEASE SKIP TO NEXT SECTION.
How many total rooms are in your household? (excluding bathrooms, hallways, or storage)
Approximately how old is your house? (If unknown, please write "unknown.")
Your answer
Does your house have the following (check box to indicate "yes")?
If no, select other and describe the specific issue, duration, and cause.
How is your home heated? Please check all that apply.
What is your primary heating source?
Are you aware of any mold in your house?
Please describe any major repairs that are currently needed on this unit. Be specific. Include severity and length of any problems, as well as any challenges to solving the problems.
Your answer
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