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f <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />9. <br />Appendix AI <br />NEIGHBORHOOD SURVEY <br />For theXoUowing questions, please check the box left of the answer most applicable. <br />Do you rent or own the property you live in? <br />D Rent □ Own <br />How long have you lived in the neighborhood? <br />□ Less than 1 year □ 2-3 years □ 5-/0 years □ 10-20 years □ Over 20 years <br />If there are children under 18 in your household, please indicate all age groups that apply <br />□ Under 5 years old □ 6-20 years old □ 12-14 years old □ 25-18 years old <br />What is the employment status of your head of household? <br />□ Employed full time □ Employed part time □ Homemaker <br />□ Student, unemployed □ Stiident, employed □ Retired <br />□ Unemployed □ Self employed <br />What^was your total household earned gross income in 1996? (wages and salary before <br />□ Under $4,999 □ $5,000- $9,999 □ $10,000-$ 19,999 <br />□ $20,000-$29,000 □ $30,000-$49,000 □ $50,000-$74,999 <br />D Over $75,000 □ Choose not to answer <br />What is the highest level of education you have completed? <br />□ Elementary school □ Some high school <br />D High school or GED □ Some technical school <br />□ Technical school graduate □ Some college <br />O Post graduate U Other <br />Is your house adequately equipped or designed to meet your needs? For example, do you <br />have or will you have mobility limitations that make it difficult for you to continue living <br />in your home? ^yes UNo UDon^tKnow <br />8. If your house needed repair would you be able to <br />get it fixed?□ Yes □ No □ Don’t Know <br />• • <br />If you own your home, would you consider major remodeling or other improvements to <br />your home if affordable loans and grants were <br />available?□ Yes □ No □ Don’t Know <br />Please see other side of page