Rural Housing Needs Survey

Question Title

* 1. Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Organization

Website

# of Full Time Staff Positions

# of Part Time Staff Positions

Total 2015 Budget (Housing + Operations)

Question Title

* 3. Estimate your average housing production and/or number of households served annually.

Question Title

* 4. How large is your service area?

Question Title

* 5. Please identify your organization's programs (check all that apply)

Single family homeownership

Single family rehabilitation

Weatherization

Multifamily rental rehab or new construction

Homeownership counseling

Homeless services

Other housing services

Other (please specify)

Question Title

* 6. Please describe your target population(s). Check all that apply.

Seniors

Families

Persons with disabilities

Homeless population

Other (please specify)

Question Title

* 7. Please identify how urgent the following housing needs are in your service area. Select "low", "medium" or "high".

	Low	Medium	High	N/A
Ending homelessness	Ending homelessness Low	Ending homelessness Medium	Ending homelessness High	Ending homelessness N/A
Rehabilitating substandard housing	Rehabilitating substandard housing Low	Rehabilitating substandard housing Medium	Rehabilitating substandard housing High	Rehabilitating substandard housing N/A
Constructing new housing	Constructing new housing Low	Constructing new housing Medium	Constructing new housing High	Constructing new housing N/A
Access to services (transportation, etc.)	Access to services (transportation, etc.) Low	Access to services (transportation, etc.) Medium	Access to services (transportation, etc.) High	Access to services (transportation, etc.) N/A
Financial literacy/homeownership readiness	Financial literacy/homeownership readiness Low	Financial literacy/homeownership readiness Medium	Financial literacy/homeownership readiness High	Financial literacy/homeownership readiness N/A
Shortage of affordable rental housing	Shortage of affordable rental housing Low	Shortage of affordable rental housing Medium	Shortage of affordable rental housing High	Shortage of affordable rental housing N/A
Declining homeownership market due to population loss	Declining homeownership market due to population loss Low	Declining homeownership market due to population loss Medium	Declining homeownership market due to population loss High	Declining homeownership market due to population loss N/A
Home accessibility for aging in place	Home accessibility for aging in place Low	Home accessibility for aging in place Medium	Home accessibility for aging in place High	Home accessibility for aging in place N/A
Shortage of affordable homes to purchase	Shortage of affordable homes to purchase Low	Shortage of affordable homes to purchase Medium	Shortage of affordable homes to purchase High	Shortage of affordable homes to purchase N/A

Other (please specify)

Question Title

* 8. Please identify the most urgent gaps in your service area (check all that apply).

Limited capacity of housing providers

Limited availability of funding

Lack of community support

Lack of infrastructure (public transportation, water/sewer, cost of well/septic, etc.)

Lack of housing counseling

Lack of affordable financing

Other (please specify)

Question Title

* 9. What are your most significant organizational needs? (Check all that apply)

Operating funds

Program funds

Staff

Equipment/Technology

Communications support

Access to housing & demographic data

Other (please specify)

Question Title

* 10. Please select the demographic changes and/or housing needs that you are seeing in your area (check all that apply).

Increasing senior population

Decreasing Millennial/Gen X population

Flat/declining income

Declining job market

Greater demand for rental housing

Increasing demand for homeownership services

Other (please specify)

Question Title

* 1. Contact Information

Question Title

* 2. Organization

Question Title

* 3. Estimate your average housing production and/or number of households served annually.

Question Title

* 4. How large is your service area?

Question Title

* 5. Please identify your organization's programs (check all that apply)

Question Title

* 6. Please describe your target population(s). Check all that apply.

Question Title

* 7. Please identify how urgent the following housing needs are in your service area. Select "low", "medium" or "high".

Question Title

* 8. Please identify the most urgent gaps in your service area (check all that apply).

Question Title

* 9. What are your most significant organizational needs? (Check all that apply)

Question Title

* 10. Please select the demographic changes and/or housing needs that you are seeing in your area (check all that apply).

Question Title

* 11. Please tell us about any other housing needs or delivery system gaps not mentioned above that you are experiencing.