Current Issues Survey

First Name *

MI

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Zip+4

Is someone in your household a United States Veteran? *

Yes

No

In your opinion, what are the greatest needs facing San Bernardino County communities? (Select up to 3) *

PUBLIC SAFETY

Which of the following do you think are helpful tools for addressing public safety concerns in our community?
(select yes, no, or undecided for each option)

Increased funding for law enforcement *

Yes

No

Undecided

Improvement of services for the homeless *

Yes

No

Undecided

Creating more affordable housing options *

Yes

No

Undecided

TRANSPORTATION

What is your primary mode of transportation to work or school? *

Car

Carpool

Public Transportation

Other

If you don't take Public Transportation, why not? (Select all that apply)

Limited or no access to service in my area

Limited hours of operation

Safety concerns

Cost

I like to have my personal vehicle for use during work hours

I do not know enough about it

ENVIRONMENT

How concerned are you about the environmental impact of warehouses in our community? *

Very Concerned

Somewhat Concerned

Not at all Concerned

How concerned are you about the development of alternative energy sources to meet our energy demands and reduce our dependence on fossil fuels? *

Very Concerned

Somewhat Concerned

Not at all Concerned

EDUCATION

Rank the following in terms of what concerns you most about accessing higher education. (0 being least, 5 being most) *

	0	1	2	3	4	5
Cost of Tuition *	Cost of Tuition - 0	Cost of Tuition - 1	Cost of Tuition - 2	Cost of Tuition - 3	Cost of Tuition - 4	Cost of Tuition - 5
Lack of Financial Aid *	Lack of Financial Aid - 0	Lack of Financial Aid - 1	Lack of Financial Aid - 2	Lack of Financial Aid - 3	Lack of Financial Aid - 4	Lack of Financial Aid - 5
Acceptance into a UC or CSU due to the enrollment cap *	Acceptance into a UC or CSU due to the enrollment cap - 0	Acceptance into a UC or CSU due to the enrollment cap - 1	Acceptance into a UC or CSU due to the enrollment cap - 2	Acceptance into a UC or CSU due to the enrollment cap - 3	Acceptance into a UC or CSU due to the enrollment cap - 4	Acceptance into a UC or CSU due to the enrollment cap - 5
Lack of preparation provided at the high school level *	Lack of preparation provided at the high school level - 0	Lack of preparation provided at the high school level - 1	Lack of preparation provided at the high school level - 2	Lack of preparation provided at the high school level - 3	Lack of preparation provided at the high school level - 4	Lack of preparation provided at the high school level - 5
Fear of taking on significant student debt *	Fear of taking on significant student debt - 0	Fear of taking on significant student debt - 1	Fear of taking on significant student debt - 2	Fear of taking on significant student debt - 3	Fear of taking on significant student debt - 4	Fear of taking on significant student debt - 5
Access to local community colleges *	Access to local community colleges - 0	Access to local community colleges - 1	Access to local community colleges - 2	Access to local community colleges - 3	Access to local community colleges - 4	Access to local community colleges - 5