Food Insecurity Survey Sample Survey - Google Forms

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11/20/2019 Food Insecurity Survey (Sample Survey)

Food Insecurity Survey (Sample Survey)


Please fill out this survey to the best of your ability! All Surveys are anonymous and will be used for
learning purposes!! Thank you again for filling out this survey!

1. What year are you?


Mark only one oval.

Freshman
Sophomore
Junior
Senior

2. What is your living situation?


Mark only one oval.

Living in Dorms
Living in Off Campus Apartment
Living with Family

Other:

3. Are you on a meal plan at USC?


Mark only one oval.

Yes
No
Maybe
Unsure

4. Have you ever been food insecure?


Mark only one oval.

Yes
No
Maybe
Unsure

5. How long were you food insecure?


Mark only one oval.

A day or two
Two weeks or longer
A month or longer
Longer than a year

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11/20/2019 Food Insecurity Survey (Sample Survey)
6. Have you used any of these resources in order to obtain food? Check all that apply
Check all that apply.

Food Bank
Homeless Shelter
Local Food Pantry
Donation from Church

Other:

7. What do you believe is the reason behind food insecurity on college campuses? Check all that
apply.
Check all that apply.

No money
Cost of tutiton
Cost of books
Meal plans

Other:

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