Poverty Survey

How many people in this household at present receive:

Rows	None	One	Two	Three	Other (Please Specify)	No Answer
Family Credit
Income Support
Job Seekers Allowance
Housing Benefit
Council Tax Benefit
Disability Working Allowance
Widow's Benefit
Sick Pay/benefit
Invalidity Pension
Attendance or Disability Living Allowance
(or Other disability benefit)
A State Retirement Pension
An occupational/private Pension

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.

I believe we should end all foreign aid until we take care of poverty in this country.

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.

I believe unmarried welfare mothers who continually have babies should have their welfare checks stopped.

I believe minorities are poor because they have been mistreated. They were not given any job opportunities etc.

I believe there is no excuse for anyone starving in America today.

I believe poor people should receive all of the free medical help they need.

I believe poor families should receive a free college education for their children.

I believe there should be a limit on the amount of money a person can make in America.

In the United States, I believe a person makes in income what his labor is worth.

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
Graffiti on walls and buildings
Teenagers hanging around on the streets
Homeless people and/or people begging
Rubbish/litter lying around
Dogs and dog mess
Home and gardens in bad condition
Vandalism and deliberate damage to property
Insults or attacks to do with someone’s race or color

Gender

Other

Age

Marital Status

Name (Optional)

First NameLast Name

Email (To Receive Results)

example@example.com