Community Testimonies
This survey is intended to be a place to share experiences and wants for communities.
I'm filling this survey out
on behalf of myself
on behalf of someone else
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Tell us about yourself
Name
First Name
Last Name
Email
example@example.com
Are you interested in sharing your story?
Yes, I want my story to make a difference and am interested in public speaking
Yes, I want my story to make a difference but am NOT interested in public speaking
Yes, but only anonymously
No, please do not quote me
Which county do you live in?
Please Select
Albany County
Allegany County
Bronx County
Broome County
Cattaraugus County
Cayuga County
Chautauqua County
Chemung County
Chenango County
Clinton County
Columbia County
Cortland County
Delaware County
Dutchess County
Erie County
Essex County
Franklin County
Fulton County
Genesee County
Greene County
Hamilton County
Herkimer County
Jefferson County
Kings County (Brooklyn)
Lewis County
Livingston County
Madison County
Monroe County
Montgomery County
Nassau County
New York County (Manhattan)
Niagara County
Oneida County
Onondaga County
Ontario County
Orange County
Orleans County
Oswego County
Otsego County
Putnam County
Queens County
Rensselaer County
Richmond County (Staten Island)
Rockland County
Saint Lawrence County
Saratoga County
Schenectady County
Schoharie County
Schuyler County
Seneca County
Steuben County
Suffolk County
Sullivan County
Tioga County
Tompkins County
Ulster County
Warren County
Washington County
Wayne County
Westchester County
Wyoming County
Yates County
How many people do you live with? (Include yourself)
How many of the above are children below the age of 18?
Select all of the following experiences you relate to either now or in the past
I'm nervous about making rent/have been homeless
I'm spending more than I can afford on childcare
I'm skipping meals to save money
I have a medical bill I don't know how to I'll be able to pay
I put off or avoid getting medical care because of the cost
I don't have a reliable form of transportation
I don't make enough money
I'm worried that everything is too expensive
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Tell us about when money has been tight
Have you ever applied for any government programs? (examples: SNAP, WIC, Public Assistance, Section 8 housing assistance, child care assistance, HEAP etc.)
Yes
No
How did it go when you tried to get the government programs you needed? What challenges did you run into?
Have you ever lost benefits or been denied benefits because of being just over the income limits?
Why did you decide not to apply for or use a public benefit service? Was it “not worth it”? (due to too many requirements, language, not enough benefit etc.)
Have you ever experienced discrimination when applying for, or accessing, housing?
Have you ever accessed support from food pantries, child care program, housing/shelter, family/friends, or other community-based org? What support (or benefits) do you need now thatyou weren’t able to access?
How have you dealt with sudden expenses or emergencies when money is tight?
(grab and drag to re-order the below boxes to the order that reflects your experience)
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Tell us about what you've shared
Have you ever shared your story in hopes to make a difference?
Yes
No
Have you participated in efforts to help others in your family or community who are dealing with similar challenges?
Yes
No
Have you participated in efforts to try to change policies to address poverty, hunger, housing insecurity, or similar issues?
Yes
No
Tell us more about any of the above experiences
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Tell us about your thoughts
What do you think a community without poverty would look like? Feel free to share your thoughts on what we can do to help make that a reality.
How common do you believe your experience is in your community?
What is something you would like a politician to know?
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Schenectady Speak-Out Questions
Would you be interested in sharing your story in front of community leaders?
Yes
No
Can I get more information?
Would you be interested in joining a training to better equip you to share your story?
Yes
No
Can I get more information?
Would you be interested in joining your local food policy council to provide guidance to policymakers on how to best address hunger and improve access to healthy, locally-grown food?
Yes
No
Can I get more information?
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Submit
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