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* 1. Do you live or work in Elyria

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* 2. What race do you identify with?

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* 3. Do you identify as Hispanic or Latino?

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* 4. What is your age?

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* 5. How do you identify?

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* 6. Have you ever served in any branch of the United States military?

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* 7. Are you a person living with a disability?

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* 8. Do you have internet at your place of residence?

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* 10. What do you feel are the greatest housing needs in Elyria?

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* 11. Including special services, community facilities, and infrastructure, what do you believe are the greatest non-housing needs in Elyria?

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* 12. Are you aware of the basic fair housing requirements (which prohibit discrimination in buying, selling, renting or lending based on race, color, religion, sex, disability, nationality or familial status)?

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* 13. Do you believe that housing discrimination is an issue in Elyria?

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* 14. Have you ever experienced housing discrimination? (select all that apply)

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* 15. If you believe or think that you or someone you know encountered housing discrimination, please indicate all of the following that apply.

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* 16. On what basis do you believe you or someone you know was discriminated against (select all that apply)

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* 17. If you believe you have been subjected to discrimination, have you reported the incident?

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* 18. If "no" to the above question, please select all reasons that apply

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