Poverty Survey
How many people in this household at present receive:
Rows
None
One
Two
Three
Other (Please Specify)
No Answer
Family Credit
1
2
3
4
5
Income Support
6
7
8
9
10
Job Seekers Allowance
11
12
13
14
15
Housing Benefit
16
17
18
19
20
Council Tax Benefit
21
22
23
24
25
Disability Working Allowance
26
27
28
29
30
Widow's Benefit
31
32
33
34
35
Sick Pay/benefit
36
37
38
39
40
Invalidity Pension
41
42
43
44
45
Attendance or Disability Living Allowance
46
47
48
49
50
(or Other disability benefit)
51
52
53
54
55
A State Retirement Pension
56
57
58
59
60
An occupational/private Pension
61
62
63
64
65
Please select how much you agree or disagree with each of the statements below:
I believe most people are poor because they are lazy and simply don't have the drive to go out and work.
Totally Agree
Agree
Neutral
Disagree
Totally Disagree
N/A
I believe we should end all foreign aid until we take care of poverty in this country.
Totally Agree
Agree
Neutral
Disagree
Totally Disagree
N/A
I believe people on welfare should not be forced to do any type of labor they consider to be below them. An engineer, for example, should not be forced to pick up garbage for the city or work as a custodian in a government building.
Totally Agree
Agree
Neutral
Disagree
Totally Disagree
N/A
I believe unmarried welfare mothers who continually have babies should have their welfare checks stopped.
Totally Agree
Agree
Neutral
Disagree
Totally Disagree
N/A
I believe minorities are poor because they have been mistreated. They were not given any job opportunities etc.
Totally Agree
Agree
Neutral
Disagree
Totally Disagree
N/A
I believe there is no excuse for anyone starving in America today.
Totally Agree
Agree
Neutral
Disagree
Totally Disagree
N/A
I believe poor people should receive all of the free medical help they need.
Totally Agree
Agree
Neutral
Disagree
Totally Disagree
N/A
I believe poor families should receive a free college education for their children.
Totally Agree
Agree
Neutral
Disagree
Totally Disagree
N/A
I believe there should be a limit on the amount of money a person can make in America.
Totally Agree
Agree
Neutral
Disagree
Totally Disagree
N/A
In the United States, I believe a person makes in income what his labor is worth.
Totally Agree
Agree
Neutral
Disagree
Totally Disagree
N/A
How common or uncommon each of these are in the area you live?
Rows
Very Common
Fairly Common
Not Very Common
Not At All Common
Noisy neighbors or loud parties
66
67
68
69
Graffiti on walls and buildings
70
71
72
73
Teenagers hanging around on the streets
74
75
76
77
Homeless people and/or people begging
78
79
80
81
Rubbish/litter lying around
82
83
84
85
Dogs and dog mess
86
87
88
89
Home and gardens in bad condition
90
91
92
93
Vandalism and deliberate damage to property
94
95
96
97
Insults or attacks to do with someone’s race or color
98
99
100
101
Gender
Male
Female
Prefer not to answer
Other
Age
Younger than 18
18-25
26-35
36-45
46-60
61 and older
Other
Marital Status
Married
Living Together
Widowed
Divorced
Separated
Never Married
Name (Optional)
First Name
Last Name
Email (To Receive Results)
example@example.com
Submit
Should be Empty: