CCC Adult Community Survey
The Churchill Community Coalition performs an annual survey to find out how adults in our community feel about substance use, mental health and youth. All surveys are anonymous. Thank you for your participation!
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1. Gender, please choose one. *
2. What is your race? (Check ALL that apply) *
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3. What is your ethnicity? *
4. Age, Please choose one.
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5. Are you the Parent of a youth 20 years or under?
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6. Are you the Grandparent of a youth 20 years or under?
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7. Do you have a youth 20 years or under living in your household?
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