Questionnaire Text

Questionnaire form view entire document: text image

Housing

Please answer the following questions about the house, apartment, or mobile home at the address on the mailing label.

15. In the past 12 months, did you or any member of this household receive benefits from the Nutritional Assistance Program?

Do 'not' include WIC, the School Lunch Program, or assistance from food banks.

[] Yes
[] No

Questionnaire instructions view entire document: text image

Housing questions 4-17

H15. On October 1, 2008, the federal Food Stamp Program was renamed SNAP (Supplemental Nutrition Assistance Program). Some states may have their own specific name for this program. If you or any member of this household received benefits from the government to buy food for your family using a benefit card, mark the "Yes" box.