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2012-2015: VOICE in Evansville
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VOICE on the GO
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Your Demographics
This information is anonymous but is vitally important in making sure we are reaching ALL people in the region! Help us by providing the following info:
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Organization(s)
If you are part of multiple organizations, please indicate each and separate them with commas.
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What is your marital status?
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Cohabitating couple household
Married
Divorced
Legal dom
Separated
Widowed
Never Married
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What is your age?
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12 or under
13-18
19-22
23-30
31-49
50-64
65-74
75 and over
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County of Residence
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Gibson
Henderson
Posey
Vanderburgh
Warrick
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Have you or anyone in your household served on active duty in the U.S. Armed Forces, Reserves, or National Guard?
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Yes
No
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Your Zip code:
What is your age?
Please enter a number less than or equal to
120
.
What gender were you assigned at birth?
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Female
Male
Don't Know
Other
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Do you or anyone in your household identify as LGBTQA+?
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Yes
No
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What is your current gender?
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Female
Male
Non-Binary/Non-Conforming/Non-Directional
Don't Know
Other
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5. Which of the following describes your race?
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Native American
Asian
Black/African American
Hawaiian or Other Pacific Islander
Two or more races
White
Other
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Which of the following describes your race?
American Indian or Alaskan Native
Asian
Black or African American
Hawaiian or Other Pacific Islander
Two or More Races
White
Other
Please specify "other" race
Are you of Hispanic or Latino/a/x origin?
Yes
No
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Do you or someone in your household identify as LGBTQIA+?
Yes, me
Yes, someone in my household
No
Prefer not to answer
Have you or anyone in your household served on active duty in the U.S. Armed Forces, Reserves, or National Guard?
Yes, me
Yes, someone in my household
No
Prefer not to answer
Do you or someone in your household have a physical or cognitive disability, either visible or not? (Please check any that apply)
Yes, I have a disability
Yes, someone in my household has a disability
No
Prefer not to answer
What is your marital status?
Cohabitating couple household
Divorced
Legal domestic partnership/civil union
Married
Never married
Separated
Single
Widowed
Other
Choose all that apply.
Please specify "other" marital status
What is the highest degree or level of school you've completed?
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No schooling completed
Nursery school
Grades 1 through 11
12th grade, but no diploma
Regular high school diploma
GED or alternative credential
Less than 1 year of college
1+ years of college, no degree
Associate's degree (i.d. AA, AS)
Bachelor's degree (i.e., BA, BS)
Master's degree (i.d., MA, MA, Meng, Med, MSW, MBA)
Professional degree beyond bachelor's degree (i.e., MD, DDS, DVM, LLB, JD)
Doctorate degree (i.e., PhD, EdD)
Educational certification
Professional licenses
Other
Please specify "other" schooling
Which best describes the sector in which you are currently or were most recently employed?
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Hospitality/Food Industry
Agriculture, Forestry, Fishing, Hunting
Arts and Entertainment
Construction
Education
Federal, State, & Local Government
Financial Services
Health/Medical
Hi-Tech
Information
Manufacturing
Military
Mining
Nonprofit
Professional Services
Real Estate, Rental, Leasing
Retail Trade
Communications/Marketing
Retail Trade
Transport & Warehousing
Utilities
Unemployed
Other
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Please specify "other" employment
What is your total estimated household income?
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Less than $10,000
$10,000 to $14,999
$15,000 to $24,999
$25,000 to $34,999
$35,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 to $199,999
$200,000 or more
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Including yourself, how many people live in your household?
Please enter a number from
0
to
100
.
Do you own or rent your residence?
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Living with Relatives/Friends
Own
Rent
Other
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Please specify "other" residence
How would the area you live in be described?
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Urban
Suburban
Rural
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Do you have access to the internet in your household?
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Yes
No
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Which type of computer do you have access to in your home?
Desktop or laptop
No computer
Smartphone
Tablet or other portable wireless computer
Other
Please specify "other" computer
What kind of internet access do you have at your home?
Broadband (ie Cable, Fiber Optic,DSL)
Cellular data plan with no other type of Intenet subscription
Dial-up
No internet subscription
Satellite
Other
Please specify "other" internet
What form of transportation do you normally use?
Bicycle/Scooter
Motorcycle
Personal vehicle
Public Transportation/Bus
Rely on relatives/friends
Taxi, Uber, Lyft, etc.
Walk
Prefer not to answer
Other
Please specify "other" transportation
What is your present religion?
Agnostic
Ancient or traditional religion
Atheist
Baha'i
Buddhist
Christian
Hindu
Jewish
Muslim
Other World Religions
Traditional or folk religion/Spiritist
Nothing in particular
Don't know
Other
Please specify "other" religion
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Describe your current housing:
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House
Apartment
Condo or Townhome
Boarding
Homeless
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Including yourself, how many people live in your household?
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Your Neighborhood
What neighborhood to do you live in? Leave blank if you don't know.
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What is the highest degree or level of school COMPLETED?
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No High School diploma
Regular High School diploma
GED or alternative credential
Some college
Associate's Degree
Professional Trade School/Certification/License
Bachelor's Degree
Master's Degree
Doctorate Degree
Other
Prefer not to answer
Your Passions
What are you passionate about or do you feel positive about in our region? List one or two short answers. For example, "healthcare" and "food security"
Passion #1
Passion #2
Carry Forward/Leave Behind
Given the history of our region (both good and unfortunate), what is good or positive in our region that you would want to carry forward to our preferred future, and what aspects would you want to leave behind? Use one- to two-word answers for each. Examples: Carry Forward "trails" and "collaboration," Leave Behind "divisiveness" and "prejudice."
Carry Forward #1
Carry Forward #2
Leave Behind #1
Leave Behind #2
Your Preferred Future
Now please take a moment to imagine our five-county region* or a specific community that you live or work 15 to 20 years in the future. Envision, create, and describe the positive changes you want to see. What are youth, young adults, and the elderly doing? What kinds of connectivity, green space, and communications exist? How are the Civic Centers working? Consider: Education, Work, Leisure, Environment, Technology, Healthcare, Diversity, etc.
Describe your preferred future for the Region:
What parts of your vision seem possible now?
In 6 months to 1 year?
In 3 to 5 years?
In 10 years?
Is your vision local or regional?
Local
Regional
Both
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Fill out the form below, and we'll be in touch. We look forward to you being a part of the change in our community!
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Based on what you envisioned/heard in the session...
What three ideas stood out or moved you?
Does anything seem possible RIGHT NOW?
Does anything seem possible THIS YEAR?
Does anything seem possible IN SEVERAL YEARS?
Is there anything you forgot to say or came to you later?
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