Covid-19 Economic Impact Survey | June 2020
This survey is intended to identify and quantify the damage the Asian American community has experienced due to the COVID-19 Pandemic.  Additionally, this survey is intended to gauge the amount of support received by the Asian American Community from federal and local government policies in response to the COVID-19 Pandemic.  

By responding to this survey, you will help to contribute to a database that tracks the status of the Asian American community.  This survey will be used to determine where support and assistance is most required.  We kindly ask that you participate in the survey to give us the data needed to further assist the Asian American community.  Private information will not be shared.

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Email *
Residential ZIP Code *
Gender *
Age
Place of Birth *
How long have you been living in the United States? *
Including yourself, how many family members live with you? *
Average Monthly Family Gross Income BEFORE COVID-19 *
Average Monthly Family Gross Income Income AFTER COVID-19 *
What is the industry of your employment? (If you're unemployed due to Covid-19, what is the industry of your most recent employment?) *
What is/was your title or position in your current or most recent employment? (Ex: Nail technician, hairdresser, driver, etc.)
What is your type of employment? *
If you are an employee, please share how the COVID-19 Pandemic has impacted your employment (check all that apply) *
Required
If you are a business owner, please share how the COVID-19 Pandemic has impacted your business (check all that apply). *
Required
What zipcode is/was your business located?
Please share how the COVID-19 Pandemic has impacted your family (choose all that apply). *
Required
Please choose all local, state, or federal government benefits or programs that you have applied for due to the COVID-19 Pandemic (even if unsuccessful). *
Required
Please choose all local, state or federal government benefits you have received or are receiving due to the COVID-19 Pandemic. (choose all that apply) *
Required
How did you hear and learn about government assistance programs? *
Who applied for the government assistance you are receiving?   *
If you are not receiving benefits or assistance from the government, what is the reason?  
If there is a reason that was not listed above for you not applying or receiving government assistance, please list your reason below
Please leave any comments or suggestions.
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