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2. The purpose of this survey is to gain an understanding of the women and girls in our community, their needs, and in what manner the commission can provide support. We appreciate your participation, and please share with others. 

4. Name
6. Email Address
8. 1. Are you a South El Monte resident?

   1. Yes
   2. No
10. 2. How do you identify?

    1. She/Her
    2. He/Him
    3. Them/They
    4. Other
12. 3. Do you identify as a woman?*

    1. Yes
    2. No
14. 4. What is your age range?*

    1. 17 or younger
    2. 18-24
    3. 25-34

    1. 35-44
    2. 45-54

    1. 55-64
    2. 65 and over
16. 5. Please select all categories that describe you:

    1. Mother
    2. Single Mother
    3. Disabled
    4. Veteran
    5. Student

    1. Homemaker
    2. Senior Citizen
    3. Business Owner
    4. LGBTQ
    5. Woman in the workforce
18. Other (Category Not Listed Above)
20. 6. Please select the categories that best describe how COVID-19 has impacted you:

    1. Loss of job
    2. Loss of home
    3. Loss of income
    4. Loss of business
    5. Loss of spouse/partner

    1. Loss of child
    2. Withdraw from school
    3. Mental wellness
    4. Physical Health
22. Other (Category Not Listed Above)
24. 7. Please list the resources or assistance that you or another woman/girl needs to help recover from the COVID-19 Pandemic ?
26. 8. What obstacles/hardships do you believe women and girls face in our community?
28. 9. How do you think the City of South El Monte can be more supportive to you?

    1. Financial literacy
    2. Housing programs
    3. Job training
    4. Goal setting

    1. Childcare
    2. Environmental protection
    3. Public Safety
30. Other (Category Not Listed Above)
32. 10. What types of resources would you like to see this new commission support or seek assistance for the advancement of women and girls in our community?

34. Thank you for taking the time to complete this survey. Your input will create a community-designed commission. 

    Stay engaged at https://www.cityofsouthelmonte.org/531/UpcomingAdvancement-of-Women-Girls-Comm

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38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field