MAVERICK FOOD PANTRY

The following questions are about your food and housing situation during the current ​Academic Year
(August 2017-May 2018). This information is being collected to gauge the severity of these issues to
allow UNO to provide better quality resources for those in need. Your name will not be associated
with your answers and your answers will not be shared. All information will remain ​confidential​.
Please circle the answer that best describes you.
1 2 3 4 5
Every Couple Once Every Couple Never
Week Times a Few Months Times a
Month Year

1. How often are you worried that your food will run out?
1 2 3 4 5

2. How often did you eat less than you felt you should because there wasn’t enough money for food?
1 2 3 4 5

3. How often were you hungry or skipped a meal because there wasn’t enough money for food?
1 2 3 4 5

4. How often were you not able to eat balanced meals or healthy foods because there wasn’t enough
money for food?
1 2 3 4 5

5. Do you have issues accessing food because of problems associated with transportation?
(Yes/No)

If Yes, please explain the difficulties you experience.

6. How often have you not had a stable or reliable place of residence?
1 2 3 4 5

7. How many times have you visited a homeless shelter as a place of residence?
1 2 3 4 5

8. How many times have you been uncertain about where you might be living in the near future?
1 2 3 4 5
 MAVERICK FOOD PANTRY

9. How many times have you felt unsafe in your place of residence?
1 2 3 4 5

10. Are you currently struggling with food insecurity? Food insecurity is ​defined as the inability to
acquire adequate and consistent food because of insufficient money and other resources.
Yes No

If Yes, please explain.

11. Are you currently struggling with housing insecurity? Housing insecurity is defined as not having a
consistent place to call home. This could include experiencing or living in poor-quality housing,
unstable neighborhoods, overcrowding, homelessness, staying with a friend, living in a vehicle,
etc.
Yes No

If Yes, please explain.

If completed, the next question will be detached from your survey.

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12. Would you be interested in a follow up with additional resources?
Yes No

If Yes, please fill out the following contact information so we can help connect you with additional
resources.
a. Full Name

b. Valid Email Address

c. Valid Phone Number

If you prefer to initiate the conversation about your concerns, please contact Cathy Pettid, Assistant Vice
Chancellor for Student Affairs at ​402.554.3523 ​or ​cpettid@unomaha.edu.