There are 238,000 people who go hungry in New Mexico. But as yet, there is no data on who goes hungry on campus. This survey is designed to collect this information for different governmental and non-governmental as well as University entities to improve access to food for the hungry in campus Thank you for your time and attention to this important matter.
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1)You are a
.
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2)Are you a
Male or
Female? |
3)Are you associated with UNM ?
Yes
No
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If Yes, which Campus
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4) What is your age:
Under 18
18-25
26-35
36-45
46-55
56-64
65 and over
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5)Number of children in your household:
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_ Number of adults in your household:
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6)Your household estimated annual income :
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Under $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 - $25,000
$25,001 - $35,000
$35,001 - $45,000
$45,001 - $54,999
$55,000 and above
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1) How often do you eat a regular, healthy diet?
Every day
At least once a week
Sometimes in a month
Sometimes in a year
Never
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2) How often do you have to skip meals?
Every day
At least once a week
Sometimes in a month
Sometimes in a year
Never
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3) How often do you feel stress about where your next meal is coming from?
Every day
At least once a week
Sometimes in a month
Sometimes in a year
Never
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4) How often do you sacrifice meals in order to feed one of your dependents?
Every day
At least once a week
Sometimes in a month
Sometimes in a year
Never
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5) Would you approach food stamps or other resources if you went hungry?
Yes
No
Unsure
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6) Please explain your response to Question 5:
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If you would feel comfortable being interviewed about your experiences
with hunger please provide the following contact information: |
Name:
Address:
City:
State:
Contact Phone:
Email:
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