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FUP/FYI Exit Survey
1.
What is your email address?
2.
First and Last Name
3.
What COUNTY do you live in?
4.
What city do you live in?
5.
What is your age?
18
19
20
21
22
23
24
25
26
27
28
29
6.
What is your gender?
Female
Male
Non-Binary
7.
Do you have a high school diploma or GED?
Yes
No
8.
Have you earned a post-secondary credential/certificate?
Yes
No
9.
Are you currently enrolled in a post-secondary educational program?
Yes
No
10.
Are you currently employed?
Yes
No
11.
If employed, what is your status?
N/A (Unemployed)
Works Part - Time (less than 30 hours a week)
Works Full - Time (more than 30 hours a week)
12.
At what age did you leave state's care (including independent living)?
17
18
19
20
21
13.
Do you have a full driver's license?
Yes
No
14.
Do you own a vehicle?
Yes
No
15.
Are you currently parenting or expecting a child?
Yes
No
16.
Why is your FUP/FYI Assistance Ending?
Voluntarily leaving program
No longer eligible due to income
Reached maximum years of assistance (36/60 months)
Eviction
17.
Do you plan to remain in the same housing unit?
Yes
No
18.
Do you feel adequately prepared to meet your basic needs?
Yes
No