[Read the list out loud Waitlisted Waitlisted Waitlisted Waitlisted Waitlisted ⃝ ⃝ ⃝ ⃝ ⃝ and have them select Lack of transportation Lack of transportation Lack of transportation Lack of transportation Lack of transportation ⃝ ⃝ ⃝ ⃝ ⃝ the primary reason] Other: Other: Other: Other: Other: ⃝ ⃝ ⃝ ⃝ ⃝ Know Doesn’t Know Doesn’t Know Know Doesn’t Know ⃝ ⃝ ⃝ ⃝ ⃝ Refused Refused Refused Refused Refused ⃝ ⃝ ⃝ ⃝ ⃝ Person 2 Person 3 Person 4 Person 5 Head of Household Do you need help to Yes Yes Yes Yes Yes ⃝ ⃝ ⃝ ⃝ ⃝ reconnect with No No No No No ⃝ ⃝ ⃝ ⃝ ⃝ family/friends or any Doesn’t Know Doesn’t Know Doesn’t Know Doesn’t Know Doesn’t Know ⃝ ⃝ ⃝ ⃝ ⃝ support system? Refused Refused Refused Refused Refused ⃝ ⃝ ⃝ ⃝ ⃝ Head of Household Person 2 Person 3 Person 4 Person 5 If permanent Yes Yes Yes Yes Yes ⃝ ⃝ ⃝ ⃝ ⃝ housing was No No No No No ⃝ ⃝ ⃝ ⃝ ⃝ available, would you Doesn’t Know Doesn’t Know Doesn’t Know Doesn’t Know Doesn’t Know ⃝ ⃝ ⃝ ⃝ ⃝ accept it? Refused Refused Refused Refused Refused ⃝ ⃝ ⃝ ⃝ ⃝ [Continue to next page] going to ask you questions about serving in the military.” “I’m Head of Household Person 2 Person 3 Person 4 Person 5
[Read the list out loud and have them select the primary reason] ⃝ Waitlisted ⃝ Lack of transportation ⃝ Other: ⃝ Know ⃝ Refused ⃝ Waitlisted ⃝ Lack of transportation ⃝ Other: ⃝ Doesn’t Know ⃝ Refused ⃝ Waitlisted ⃝ Lack of transportation ⃝ Other: ⃝ Doesn’t Know ⃝ Refused ⃝ Waitlisted ⃝ Lack of transportation ⃝ Other: ⃝ Know ⃝ Refused ⃝ Waitlisted ⃝ Lack of transportation ⃝ Other: ⃝ Doesn’t Know ⃝ Refused Head of Household Person 2 Person 3 Person 4 Person 5 Do you need help to reconnect with family/friends or any support system? ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused Head of Household Person 2 Person 3 Person 4 Person 5 If permanent housing was available, would you accept it? ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused ⃝ Yes ⃝ No ⃝ Doesn’t Know ⃝ Refused [Continue to next page] “I’m going to ask you questions about serving in the military.” Head of Household Person 2 Person 3 Person 4 Person 5
2018-Working-Survey-1.docx