Survey — Stadium Stompers

We are collecting information to map the dimensions of the issues facing the North Central community.

What are your top three worries:

Select all that apply.

Housing

Food

COVID

Wifi Connection

Childcare

Other

Housing: Are you behind in your rent or mortgage payments?

Select one.

Food: Do you have enough to eat?

How are you feeling? Have you been diagnosed with COVID? When?

Covid Vaccine: Have you been contacted or signed up for a COVID vaccine?

Do you have children or grandchildren in public school?

If you have kids/grandkids in public school do you have everything you need to help them get their work done?

Do you have access to WiFi?

Select one.

Do you have other issues?

Elaborate in the box below.

If you selected other, please elaborate in this box.

What would you like to see investment in?

Housing? Education? Jobs? Other?

Name

First Name

Last Name

Address

Birthdate

mm/dd/year

Identified Gender

Race & Ethnicity

Select one.

How long have you lived in North Philly?

Which form of contact would you prefer?

What block do you live on?