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Feeding Brookings Guest Survey 2023
Please fill out this survey to help us serve you better! The information gathered will also be used for grant applications to help fund Feeding Brookings.
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* Indicates required question
How often do you visit Feeding Brookings?
*
Every week
2-3 times per month
6-12 times per year
1-6 times per year
How long have you been a guest of Feeding Brookings?
*
3 months or less
3-6 months
6-12 months
1-2 years
3-5 years
5+ years
What type of hygiene items would you like to receive through Feeding Brookings? Check all that apply.
*
bath soap
shampoo
toothpaste
toothbrush
dish soap
deodorant
laundry detergent
toilet paper
Other:
Required
Please rate the meat options.
*
I do not use this item
Use this item, but prefer something else
I like this item
Wish this was in the box every week!
ground beef
beef stew
frozen chicken
canned chicken
canned tuna
frozen fish
canned fish (salmon, etc)
hot dogs
I do not use this item
Use this item, but prefer something else
I like this item
Wish this was in the box every week!
ground beef
beef stew
frozen chicken
canned chicken
canned tuna
frozen fish
canned fish (salmon, etc)
hot dogs
Please rate the produce options.
*
I do not use this item
Use this item, but prefer something else
I like this item
Wish this was in the box every week!
bananas
apples
carrots
onions
potatoes
tomatoes
canned green beans
canned corn
canned peas
canned tomatoes
canned mixed fruit
canned pears
canned peaches
I do not use this item
Use this item, but prefer something else
I like this item
Wish this was in the box every week!
bananas
apples
carrots
onions
potatoes
tomatoes
canned green beans
canned corn
canned peas
canned tomatoes
canned mixed fruit
canned pears
canned peaches
Please rate the pantry options.
*
I do not use this item
Use this item, but prefer something else
I like this item
Wish this was in the box every week!
cereal
spaghetti noodles
mac and cheese
peanut butter
bread
pancake mix
rice
Skillet dinners/hamburger helpers
chicken noodle soup
navy beans
I do not use this item
Use this item, but prefer something else
I like this item
Wish this was in the box every week!
cereal
spaghetti noodles
mac and cheese
peanut butter
bread
pancake mix
rice
Skillet dinners/hamburger helpers
chicken noodle soup
navy beans
Please rate the snack options.
*
I do not use this item
Use this item, but prefer something else
I like this item
Wish this was in the box every week!
pistachios/almonds/walnuts
crackers
granola bars
Bel cheese
pudding
popcorn
cookies/desserts
I do not use this item
Use this item, but prefer something else
I like this item
Wish this was in the box every week!
pistachios/almonds/walnuts
crackers
granola bars
Bel cheese
pudding
popcorn
cookies/desserts
Please rate the dairy/miscellaneous options.
*
I do not use this item
Use this item, but prefer something else
I like this item
Wish this was in the box every week!
eggs
milk coupons
cheese
mayo/salad dressing
ketchup/BBQ sauce
cooking oil
I do not use this item
Use this item, but prefer something else
I like this item
Wish this was in the box every week!
eggs
milk coupons
cheese
mayo/salad dressing
ketchup/BBQ sauce
cooking oil
Which of the following do you have to store and prepare food? Check all that apply.
*
Refrigerator
Freezer
Oven
Stove
Microwave
Crock pot
Can opener
Other:
Required
Please indicate the number of people in your household that fall in each age category.
*
0 people
1 person
2 people
3 people
4 people
5 people
6 people
Age 0-6 years
Age 7-13 years
Age 14-17 years
Age 18-30 years
Age 31-49 years
Age 50-64 years
Age 65-74 years
Age 75-84 years
Age 85+ years
0 people
1 person
2 people
3 people
4 people
5 people
6 people
Age 0-6 years
Age 7-13 years
Age 14-17 years
Age 18-30 years
Age 31-49 years
Age 50-64 years
Age 65-74 years
Age 75-84 years
Age 85+ years
Please indicate the number of people in your household that fall in each ethnicity category.
*
0
1
2
3
4
5
6
7
8
9
10
11
12
Black/African American
Asian
White/Caucasian
Hispanic/Latino
Native American
Pacific Islander
Multi-Racial
Others
Unknown
0
1
2
3
4
5
6
7
8
9
10
11
12
Black/African American
Asian
White/Caucasian
Hispanic/Latino
Native American
Pacific Islander
Multi-Racial
Others
Unknown
Please indicate the number of people in your household for each gender listed.
*
0
1
2
3
4
5
6
7
8
9
10
Female
Male
Transgender
Unknown
0
1
2
3
4
5
6
7
8
9
10
Female
Male
Transgender
Unknown
Using your household size and total annual income for your household, please select the column (A, B, C, or D) your household income falls at or below.
Choose
A
B
C
D
What is your household size?
Choose
1
2
3
4
5
6
7
8
9
10
11
12+
Why is Feeding Brookings important to you?
*
Your answer
What other suggestions do you have? e.g. other food items to include, distribution ideas, etc.
*
Your answer
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