GENERAL - DEMOGRAPHICS

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* 1. Please select the county you live in and/or represent

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* 2. Are you male or female?

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* 3. What do you consider to be your primary racial group?

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* 4. Family Type

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* 5. Which category below includes your age?

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* 6. How many children (under the age of 5) live in your household?

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* 7. Which of the following best describes your highest level of education?

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* 8. What is your employment status?

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* 9. Source of household income? (check all that apply)

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* 10. Do you receive Food Stamps?

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* 11. Please select the category that best represents your annual household income.

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* 12. Are you a caregiver?

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* 13. Do you have a child, grandchild, and/or foster child in your household who attends Head Start?

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* 14. Is anyone in the household on active military duty?

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* 15. Is anyone in the household a veteran?

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