School Food Mobile Client Survey

Welcome!
Thank you for taking the time to fill out this survey, your feedback is critical to ensure we are providing the best resources for you and your family. Please be rested assured that your responses to this survey will be kept confidential and the information you provide will only be used to help Gleaners enhance our School Food Mobile and Best Food Forward programs.

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* 1. Not counting today, have you visited this school food mobile during the past 12 months?

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* 2. How much of the food that you receive from this site are you and your family able to use?

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* 3. Does the food provided at this school food mobile meet your dietary/cultural/religious food needs?

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* 4. If our food is not meeting your dietary/cultural needs, please tell us what types of food you would like to see us add to the distribution.

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* 5. Does the food provided at this school food mobile meet your dietary/cultural/religious food needs?

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* 6. If you have NOT used at least one of the recipes provided, please indicate why you have not.

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* 7. My family’s financial situation improved when I received food from this school food mobile.

To help us understand if and how the School Food Mobiles may impact your family and your household, please answer the following True or False statements.

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* 8. My family’s financial situation improved when I received food from this school food mobile.

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* 9. Receiving the food helped to reduce some of the stress I have about making ends meet.

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* 10. Receiving the food made it easier for me to deal with other challenges I have in life

This section is OPTIONAL.
To help us understand the people we are serving, please complete the following demographic information. Your information will be kept confidential and will not be shared outside this survey.

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* 11. Please tell us the name of the school where you attend the mobile. 

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* 12. How many people, including yourself live in your house.

0 20
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i We adjusted the number you entered based on the slider’s scale.

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* 13. How many children, under the age of 18 live in your household?

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i We adjusted the number you entered based on the slider’s scale.

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* 14. Please select your race/ethnicity. 

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