Lykins Neighborhood Association Survey
1.

 

Para la encuesta en español, haga clic aquí.


Please rate your concern about the following items that are impacted by the Coronavirus  on a scale from 1 to 5. 1 means that you are not concerned at all at all and 5 means you are very concerned.


 Not concerned at all    Very concerned 
Concerned about unemployment due to the Coronavirus?
Concerned about childcare so that you can work?
Concerned about going out to get groceries because of a health risk?
Concerned about paying for groceries?
Concerned about the health of a small business?
  • Comment:

  • 500 characters left.
2.
The Lykins Neighborhood motto is: "Neighbors Helping Neighbors".  There is no better time than now to bring that saying to life.  Those of us who have time or other resources that we can use to help our neighbors through the problems that the Coronavirus is causing can do a lot to make life better for our neighbors in need.  The work we do now will make this a stronger neighborhood for a long time to come.  Please let us know in which volunteer roles you might be willing to help out.
 No Yes    
Grocery shopping or delivery?    
Meals for people in need?    
Shelter or assistance for homeless person?    
Grow a vegetable garden to help sure people have fresh food over the summer?    
Work with at least one other person to provide childcare for someone who needs to work?    
  • Comment:

  • 500 characters left.
3.
What technology do you have in your home?
computer
cell phone
notebook
internet service
none of the above
4.

What might lift your spirits these days?

 

350 characters left.
5.
Please give us a little personal information.

First Name:
Last Name:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:

6.

Any other Coronavirus issues you are concerned about that you would like to tell us? 

 

50 characters left.