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Physical address is required to process the survey. Please no PO boxes.
Household is the total number of people living in the house. This includes long-term guests, roommates, older family members, and all young people 18 and under.
First, find the number of total person(s) in the household listed below, then check whether the total household income listed is above or below the dollar figure listed.
This information is strictly confidential. Please provide the number of household members in each racial group.
Please type in the number of household members that are Chicano, Hispanic, Latino, or Indigenous Latino.
Thank you for completing this survey! The information provided will assist in applying for a Community Development Block Grant.
This field is not part of the form submission.
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