Online Forms

Housing Tools and Strategies General Community Feedback

2. Please submit any feedback or questions regarding the Housing Tools and Strategies project.

4. How are you learning about the Housing Tools and Strategies working group's efforts?

   1. Working group member
   2. Attended the meeting as audience
   3. Viewing materials online

6. How did you hear about the Housing Tools and Strategies working group and its efforts?

10. Contact Information
    If you have a specific question you would like staff to respond to or if you would like to be added to the interested parties list, please provide contact information below.

    If you have a specific question you would like staff to respond to or if you would like to be added to the interested parties list, please provide contact information below.

12. First Name

13. Last Name

15. Home or Cell Phone Number

16. Email Address

18. What is the best way to contact you?

    1. Telephone
    2. Email

19. Would you like to be added to the interested parties list?

    1. Yes
    2. No

23. Demographic Information
    We do not discriminate on the basis of race, age, ability, income, or gender identity/expression. The following questions are all optional.

    We do not discriminate on the basis of race, age, ability, income, or gender identity/expression. The following questions are all optional.

25. Ward Number

26. Find Your Ward
    Find Your Ward

27. Neighborhood

29. What is your gender?
    -- Select One --MaleFemaleAnother gender identity

30. Another gender identity

32. Select all the races/ethnicities you identify with:

    1. American Indian or Alaska Native
    2. Asian
    3. Black or African American
    4. Hispanic, Latino, or Spanish origin
    5. Middle Eastern or North African
    6. Native Hawaiian or Other Pacific Islander
    7. White
    8. Another race/ethnicity

33. Another race/ethnicity

35. What is your age?
    -- Select One --17 and under18-2425-3940-5960 and over

36. What is your residence type?
    -- Select One --OwnRentOther

38. Please estimate your total household income for 2017 before taxes.
    -- Select One --Less than $35,000$35,000-74,000$75,000+I don't know

39. Is your annual household incomes less than $43,000?
    -- Select One --YesNo

Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit

* indicates a required field