WHA Resident Services Questionnaire

This survey will help us provide residents with support throughout the 2020 year and gauge resident interest in specific services.

All fields are required. 

Please complete by June 12.

Survey WITH Kids

On a scale from 1 to 10, are your food needs being met?

Are you interested in having any of the following items dropped off to you? Check all that apply.

Do you need a mask for each member of your household?

Would you be interested in drive-in movie nights?

Would you be willing to travel to a drive-in movie theater?

Ex: The Original Southington Drive-in Movie

Please list the names and ages of all children under the age of 18 who are currently living with you.

Are you willing to do an At-Home weekly cooking activity with your child(ren)?

(Ingredients will be supplied to feed family size)

Please check all the supplies that you own:

What is your child(ren)’s favorite meal of the day? 

Which meal are you available to help your child participate in? (Check all that apply)

Does your child(ren) have any dietary restrictions?

Does your family follow a specific diet plan?

Do you feel like your child(ren) are being kept on track for their upcoming school year?

If you are currently working, what are your work hours?

Do you anticipate working during the summer between the hours of 9 and 5pm?

Would you allow your children to participate in Zoom calls?

What at home activities are your child(ren) interested in?

What activities are your child(ren) currently doing to pass the time?

What outdoor sidewalk activities do your children own? (Please check all that apply)

Is your child(ren) interested in completing craft activities at home?

Does your child have access to a computer with internet?

On a scale from 0 to 10, what is your interest level in online activities?

On a scale from 0 to 10, how much supervision or guidance does your child require to complete online tasks?

On a scale from 0 to 10, how comfortable are you with your children participating in activities with other children  at this time?

Are you confident that your child understands Social Distancing and is able to follow social distance guidelines while unattended?

Do you have childcare plans for summer 2020?

Will your child(ren) be attending a camp this summer?

Do you have transportation?

Do you anticipate having childcare costs this summer?

If yes, what is the weekly cost?

If we offered half day activites for your children during the summer, which session would they be able to attend?

(check all that apply)


By submitting your survey, you agree to share your answers with Westport Housing Authority and acknowledge that you may receive notifications from Westport Housing Authority in your e-mail inbox moving forward.