National Research Survey Form
Please complete the National Research Survey Form to help us gather valuable insights. Your responses are anonymous and will be used for research purposes only.
Which region do you currently reside in?
*
Please Select
Northeast
Midwest
South
West
Other
What is your age group?
*
18-24
25-34
35-44
45-54
55-64
65 or older
Prefer not to say
How would you rate your overall satisfaction with public services in your area?
*
1
2
3
4
5
Please indicate your level of agreement with the following statements:
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Public services are accessible.
1
2
3
4
5
Local infrastructure meets my needs.
6
7
8
9
10
I feel informed about community decisions.
11
12
13
14
15
How frequently do you participate in community events?
Never
Rarely
Sometimes
Often
Always
Which sources do you rely on most for national news? (Select all that apply)
Television
Online news websites
Social media
Radio
Print newspapers
Other
How optimistic are you about the future of the country?
Not at all optimistic
1
2
3
4
5
6
7
8
9
Extremely optimistic
10
1 is Not at all optimistic, 10 is Extremely optimistic
What is the biggest challenge facing your community today?
Do you have any additional comments or suggestions?
Submit Survey
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