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Please help us learn about where and how you shop for food! This survey will help inform the Northeast Indiana Local Food Assessment and Strategic Plan funded by the generous support of the UDSA and the St. Joseph Community Health Foundation.

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* 1. What are the TOP THREE places your family buys or receives the food you eat?

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* 2. How often does your family eat local food, meaning food that is grown, raised or harvested on farms in the 11 county region of Northeast Indiana?

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* 3. Where does your family buy or receive the local food you eat? (Check all that apply.)

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* 4. What would motivate you to buy local food at farmers markets, farm stands, or local stores more often? (Check all that apply.)

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* 5. What local foods from local farms does your family eat regularly? (Check all that apply.)

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* 6. Roughly, how much money does your family spend on local food per month?

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* 7. Do you ever use SNAP/EBT or WIC/Senior Voucher benefits to buy local food?

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* 8. In which zip code do you live?

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* 9. What is your race/ethnicity?

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* 10. How many people in your household are under age 18?

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* 11. How many people in your household are over age 65?

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* 12. Please mark whether your family income is Above OR Below these levels. (Based on the number of persons in your household.)

  1 Person ($49,300) 2 Persons ($56,350) 3 Persons ($63,400) 4 Persons ($70,400) 5 Persons ($76,050) 6 Persons ($81,700) 7 Persons ($87,300) 8 Persons ($92,950)
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