It's time again to update our progress in the areas of self-reliance. This is our annual survey and will help us assess the needs and interests of the members of our ward. If you haven't already done so, please fill one out and return to me as soon as possible. Once I have the information, I will post the results as compared to last years stats. You can either email your responses to me or print out the survey and give to me directly. All information is kept strictly confidential!
Thanks!
Kristine Guerrero
tovselfreliance@gmail.com
Annual Self-Reliance
Questionnaire
List in order of importance the areas you would like
to work on where 1 is the most important and 7 the least.
______ Employment
______
Food Storage
______
Gardening
______Finances
______
Education and Literacy
______
Physical Health
______ Emergency Planning
______Other (please list) _______________________________________________________
How many months of long term home storage do you estimate you
have? It is suggested that we have at least a 1 year supply. _____________________________________________________
How many months of your every day food to you estimate
you have? It is suggested
that we have at least a 3 month supply. _____________________________________________________
How many days/weeks/months worth of water do you
estimate you have? It is suggested
that we have at least a 2 week supply.
______________________________________________________
Please tear here and return to self-reliance committee.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ __ _ _ _
Name(s)_______________________________
Email(s)________________________________________
Cell Phone number(s) _____________________________(for
emergency situations only not to be shared)
Please check lf you have any of the following. Use the back of this page for
additional space if needed.
_____CPR and first aid
training, if you are in any medical field please specify below
_____Any other emergency
training, please list below
_____HAM Radio and/or
operator license, please specify below
_____Two-way radio
_____Off road transportation,
i.e. motorcycle, 4wd vehicle, ATV, etc. please list below
_____RV/motor
home/Van/Truck, etc., please specify below
_____Pool/water filtration,
please list below
_____Security training, i.e.
police/security, hands on combat/fighting please list below
_____Security/weapons, i.e.
firearms, ammunition, etc. please list below
_____Camping and/or cooking
equipment, please list below
_____Generator, please list
type below
Please list any specific area of
talents, interests, training, education, skills, etc. not listed above
(mechanical, electrical, plumbing, lifeguard, child care, accounting,
computers, food handling, gardening/ farming, etc.).
