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Paper Forms Housing & Community Development Survey

  1. The City of Dubuque receives Community Development Block Grant (CDBG) federal funds each year for housing and community development projects. The Housing and Community Development Department want you to have a voice in how the City invests this money. Please assist us by filling out this survey.

  2. In your responses below, which area of the City of Dubuque are you addressing?*

  3. If you are addressing a specific neighborhood, please mark all that apply.

  4. Income Chart

  5. What is your race (select all that apply)

  6. What is your ethnicity?

  7. What is your age?

  8. 1. Suitable Living Environment:
    For each of the following categories, please rate every item by checking the appropriate box indicating the level of need you see in our community.

  9. Community Facilities

  10. Senior Center

  11. Youth Center

  12. Child Care Center

  13. Homeless Facility

  14. Park and Recreational Facilities

  15. Health Facilities

  16. Community Center*

  17. Neighborhood Facilities

  18. Parking Facilities

  19. Other

  20. Infrastructure

  21. Accessible Curbs

  22. Water/Sewer

  23. Street/Alley

  24. Street Lighting

  25. Sidewalk Improvements

  26. Public Wall/Steps

  27. Drainage

  28. Other

  29. Special Needs

  30. Disabled Centers/Services

  31. Accessibility Improvements

  32. Domestic Violence Facilities

  33. Homeless Shelters

  34. Other

  35. Public Services

  36. Youth Services

  37. Mentoring Services

  38. Health Services

  39. Mental Health Services

  40. Substance Abuse Services

  41. Elderly Services

  42. Homeless Services

  43. Education

  44. Recreational Programs

  45. Child Care Services

  46. Transportation

  47. Neighborhood Services

  48. Crime Prevention

  49. Leadership Development

  50. Other

  51. 2. Decent Housing:

  52. Affordable Single Family Housing

  53. Affordable Rental Housing

  54. Housing for Disabled

  55. Homeownership Assistance

  56. Residential Rehabilitation

  57. Senior Housing

  58. Code Enforcement

  59. Historic Preservation

  60. Lead Paint Removal

  61. Fair Housing

  62. Tenant/Landlord Counseling

  63. Other

  64. 3. Creating Economic Opportunities:

  65. Business and Jobs

  66. Workforce Training

  67. Local Business Support

  68. Summer Youth Employment

  69. Job Readiness Skills

  70. Technical Assistance for Business

  71. Financial Assistance for Business

  72. Micro-Enterprise Assistance

  73. Job Creation/Retention/Training

  74. Attracting New Businesses

  75. Other

  76. 4. Area of Interest

  77. Thank you.

    Thank you for taking a few minutes of your day to complete this survey. The results of the survey will be compiled and presented to the Community Development Advisory Commission and considered during the development of the 5 year Consolidated Plan for the use of CDBG funds.

  78. Leave This Blank:

  79. This field is not part of the form submission.