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Alaska First Survey
This form requires the Gravity Forms Survey Add-On. Important: Delete this tip before you publish the form.
Name
First
Last
Email
(Required)
How long do you plan to stay in Alaska?
Which three issues most directly affect you and/or your family?
(Required)
Price of fuel
Discrimination
Lack of job opportunity
Health costs
Condition of infrastructure
Crime/Violence
Access to quality education
Are you satisfied with the current job and economic opportunities provided in Alaska? On a scale, 1 being very dissatisfied and 5 being very satisfied.
(Required)
1
2
3
4
5
Do you think our State is headed in the right direction?
On a scale, 1 being very dissatisfied and 5 being very satisfied, rate the following.
Alaska's healthcare
(Required)
1
2
3
4
5
Alaska's in-state transportation
(Required)
1
2
3
4
5
Alaska's post-secondary education opportunities
(Required)
1
2
3
4
5
Alaska's job and economic opportunity
(Required)
1
2
3
4
5
How did you hear about my campaign?