Scan 2
Scan 2
11. How would you rate the quality of the following City emergency services?
13. During the last year, do you think crime in your neighborhood has:
Increased Increased Not Decreased Decreased
Dramatically_ Somewhat Changed _ Somewhat _ Dramatically_
14. In your neighborhood are there any specific areas that you have concerns about?
Yes_ No__ Explain: _
15. Is there anything in your neighborhood that needs to be attended to by.the City?
Yes_ No__ If yes, explain: _
16. Are you aware of anyone in either your household or your neighborhood that is in need of
after school child services and/or youth recreation programs? Yes No
If yes, what is the need and location of the need? _
17. Are you aware of anyone in your household or neighborhood that is in need of
emergency utility aid services? Yes No
If yes, what is the location? _
18. Are you aware of anyone in your household or in your neighborhood that is in need of
job training and/or job counseling services? Yes No
If yes, what is the location? _
19. Are you aware of anyone in your household or in your neighborhood that is in need of
substance abuse counseling/recovery program services? Yes_ No_
If yes, can we leave program services information with you? Yes _ No_
20. Are you aware of anyone in your household or in your neighborhood that has food and/or
clothing needs? Yes_ No__
If yes, what is the need and location of the need? _
21. If you are a renter are there any unsafe conditions that need to be fixed at this residence
that you would like our assistance in contacting the landlord with? Yes_ No_
If yes, may our Code Enforcement Dept. contact you directly? Yes No