Assemblywoman

Latrice M. Walker

Assembly District 55

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Assembly Home

Constituent Survey

May 9, 2022

Greetings to the 55^th Assembly District family. Please complete the constituent survey and let us know how we’re doing, Thank you.

* Indicates Required Field

Title

First Name *

Middle Initial

Last Name *

Suffix

Phone Number *

Mobile Number

Email *

Confirm Email *

Address (Street Address, P.O. Box, Company Name, c/o)*

Street Address, P.O. Box, Company Name, c/o

Address Line 2 (Suite, Unit, Building, Floor, etc.)

Suite, Unit, Building, Floor, etc.

Apt Number

City *

State *

Zip *

How Are We Doing?

Thank you to my 55th Assembly District family for your continued support. Please take a few minutes to complete the following survey, which will help my staff and I better serve you.

Please rate your level of concern about crime in the neighborhood.

1 Not very concerned

5 Extremely Concerned

Please rate your level of concern about the COVID-19 pandemic.

1 Not very concerned

5 Extremely Concerned

If you have called the district office or visited in person, please rate the quality of service you received.

Courteous?

Yes

Informative?

Yes

Prompt and efficient?

Yes

I have not called or visited.

How well informed do you feel about what’s going on in the district?

1 Not at all.

5 Completely informed.

What is the best way to convey information about the district to you?

Mail

Phone

What is your age group?

18-25

26-35

36-45

46-55

56+

How long have you lived in the district?

0-2 years

2-5 years

6-10 years

10+ years

How Are We Doing?

Please answer the following questions with short responses.

What type of programming or events would you like to see in the district?

Do you subscribe to the 55th Assembly District’s weekly newsletter?

Yes

If not, please provide your email address, so we can add you to the distribution list.

User Name

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