Storied Streets Pre-Screening Survey

How old are you?*

What is your gender?

What school do you attend?*

Class through which the film program is offered?*

Name of teacher? ?*

My race/ethnicity is ...*

Financially, I consider my family to be…*

Do you think homelessness is a problem?*

Do you consider homelessness to be a problem in your neighborhood?*

What personal experiences have you had with homeless individuals? (check all that apply)*

I see them when I go to places outside my immediate neighborhood
I have given money, clothes, or food to a homeless person
I see them when I walk around the neighborhood where I live or go to school
I have done community service where there are homeless individuals (soup kitchens, shelters or other programs that benefit the homeless)
I have had conversations with homeless people
I personally know and/or am friends with someone who is or has been homeless
I have not had any personal experiences with homeless individuals
I am homeless or have been in the past

When I see a homeless person I generally feel… (check all that apply)*

Comments

Tell us your favorite film so we know you aren't a robot 🙂*