COVID-19 Community Needs Survey
For people living in West Virginia and the bordering counties of KY, OH, PA, VA, and MD
In which state do you reside? (This survey is for people in WV and the surrounding states within 30 min of the WV border) *
What is your gender? *
Are you currently employed?
If not employed, would you be willing to work during the COVID-19 crisis?
How have your work hours changed due to COVID-19?
What is your primary concern AT THIS TIME related to COVID-19?
What is your primary concern ONCE THE PANDEMIC ENDS for you or your family?
Do you feel you could benefit from enrolling in free career training during the COVID-19 crisis?
Would you be more likely to enroll in free career training during the COVID-19 crisis if it was online only?
Do you currently have access to reliable internet and a computer? *
Do you feel your computer skills are good enough for you to attend online training?
What do you feel is holding you back from achieving your career or financial goals?
Your answer
How many hours per week can you dedicate to online career training?
What length of online class would you be interested in (Check all that apply)
What time of day would you be available to attend online training? (Check all that apply)
What type of online class would interest you? (Check all that apply)
What long-term effects will this crisis have on you/your family?
Your answer
Are you or anyone in your household considered “high-risk” for COVID-19?
Do you depend on public transportation (e.g. city buses, Uber/Lyft, trains)?
How many children (people under 18) live in your household or do you share custody of?
How many children, adults with special needs, or elderly people do you need to find care for if you go to work?
What is your age? *
What is your race?
How many people live in your household? (Include yourself. Do not include roommates you don't financially support or who don't financially support you.)
What is your approximate HOUSEHOLD income?
What is your highest education level completed?
Never submit passwords through Google Forms.
This form was created inside of West Virginia Women Work, Inc.. Report Abuse