Working Vermonters Survey
The purpose of this survey is to collect the stories of everyday Vermonters living and working in Vermont. What have been the impacts of COVID-19 on your daily life?? This is a collaborative project between the Public Assets Institute and the Center for Research on Vermont. The information here is confidential to you and will not be shared with anyone (beyond the principal researcher) without your permission. Before taking the survey please read the Research Information Sheet at this link
We will close this survey October 11 -- so please respond before then.Thank you!
What town do you live in? *
When it comes to where you live do you consider yourself a *
Please tell us what kind of work you do.
If you have been working, please tell us some of your work-related experiences over the last year.
During the past year have you or a relative lost your job, gone on unemployment, or had your hours at work reduced or increased? And is this related to COVID-19 in any way? Please explain.
Are there other ways that COVID-19 has impacted you over the last year? Please explain.
When it comes to living in Vermont over the last year, what has it been like for you? How are you doing?
Age? Please list your age, or the range your age falls in (ie between 20 & 30; 30 & 40 and so on)
Sex *
How large is your family (that you live with)? *
If you have children at home, what ages are they? (Check all that apply)
What is the highest level of education you have attained? *
What was your income in 2019?
Clear selection
Have you qualified for Earned Income Tax Credit (EITC) in the past two years?
Clear selection
Have you received support from any of the following programs before or after March 13, 2020?
Child care assistance (CCFAP)
Medicaid or Dr. Dynasaur
Reach Up
Before March 13
After March 13
Race & ethnicity *
Is there anything else you would like to add?
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy