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* 1. What is your zip code?

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* 2. What is your age?

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* 3. What best describes your household?

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* 4. What best describes your home?

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* 5. How many live in your home?

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* 6. What is your employment status?

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* 7. If seeking employment, what platform do you use?

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* 8. Is anyone in your household active duty military?

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* 9. Is anyone in your household a US veteran?

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* 10. What is your annual household income?

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* 11. What sources of income has your household had in the past year? (check all that apply)

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* 12. What is your highest grade level/education completed?

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* 13. Do you have a desire to further your education?

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* 14. Are you familiar with CLM Community Action?

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* 15. In the past year have you received assistance from CLM Community Action?

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