Complete this survey to have a chance to win a gas or grocery card! Surveys must be completed and either dropped off or mailed to 907 W. Pines Road, Oregon, IL 61061 or 510 Lincoln Hwy, Rochelle, IL 61068 by June 13, 2023 Phone Number or Email* What town do you currently live in? Does anyone in your household currently receive food stamps, SNAP, or WIC benefits? OYes, someone does O No, no one does Does your neighborhood have too many, too few, or about the right number of grocery stores? OThe right amount O Far too many O Too many O Too few O Far too few On average, how far do you have to drive to do your grocery shopping? 00-5 miles O 6-10 miles About how often do you eat fast food? O Every day A few times a week O Less than a few times a month O Never When you do choose to eat fast food, what is the main reason? O Convenience O Time O Price O Special Occasion Other (please specify reason at end of survey) O A great deal O A little O None at all How would you rate your amount of knowledge on the aspects of preparing a nutritious meal? OA lot OA moderate amount O 11 miles + Do you feel you have the ability to support the costs associated with purchasing nutritious foods? O Strongly Agree O Agree ONeither agree or disagree O Disagree O Strongly Disagree G Please provide any additional comments or concerns regarding the current food environment in your town and/or county. COLLECORATY A few times a month HEATHEMAT Want to take survey online instead? Scan Here Complete this survey to have a chance to win a gas or grocery card ! Surveys must be completed and either dropped off or mailed to 907 W. Pines Road , Oregon , IL 61061 or 510 Lincoln Hwy , Rochelle , IL 61068 by June 13 , 2023 Phone Number or Email * What town do you currently live in ? Does anyone in your household currently receive food stamps , SNAP , or WIC benefits ? OYes , someone does O No , no one does Does your neighborhood have too many , too few , or about the right number of grocery stores ? OThe right amount O Far too many O Too many O Too few O Far too few On average , how far do you have to drive to do your grocery shopping ? 00-5 miles O 6-10 miles About how often do you eat fast food ? O Every day A few times a week O Less than a few times a month O Never When you do choose to eat fast food , what is the main reason ? O Convenience O Time O Price O Special Occasion Other ( please specify reason at end of survey ) O A great deal O A little O None at all How would you rate your amount of knowledge on the aspects of preparing a nutritious meal ? OA lot OA moderate amount O 11 miles + Do you feel you have the ability to support the costs associated with purchasing nutritious foods ? O Strongly Agree O Agree ONeither agree or disagree O Disagree O Strongly Disagree G Please provide any additional comments or concerns regarding the current food environment in your town and / or county . COLLECORATY A few times a month HEATHEMAT Want to take survey online instead ? Scan Here