School Food Mobile - Take Two

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?

Yes I have visited this mobile in the past 12 months. If yes, about how many times have you visited this mobile..

No, I have not visited this mobile in the past 12 months. Please share with us why you have not visited this mobile.

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

1-25%

26-50%

51-75%

76-100%

None

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

The food I receive meets my families dietary/cultural needs.

The food I receive somewhat meets my families dietary/cultural needs.

The food I receive does not meet my families dietary/cultural 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?

Extremely confident

Very confident

Somewhat confident

Not so confident

Not at all confident

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

Not applicable (I have used the recipes)

I do not care for the recipes.

I do not have all the kitchen utensils/equipment needed to prepare the recipe.

I have not received the recipes.

I do not have all the ingredients to make the recipes.

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

True

False

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.

True

False

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

True

False

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

True

False

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.

Clear

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?

Clear

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

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* 14. Please select your race/ethnicity.

White

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race