FAMILY SELF-SUFFICIENCY ANALYSIS

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FIRST & LAST NAME(Required)

YOUR EMAIL ADDRESS(Required)

EMPLOYMENT OR SELF-EMPLOYMENT(Required)

3 - Employed full-time.

2 - Employed part-time.

1 - Unemployed for one month or longer.

INCOME(Required)

3 - Income is always higher than expenses.

2 - Income meets expenses most of the time.

1 - Little or no income.

FOOD(Required)

3 - Always have a 7-day supply of food in my home.

2 - Usually have enough food in my home to meet basic needs.

1 - Usually do not have enough food to meet basic needs.

CHILDCARE FOR WORK OR SCHOOL(Required)

3 - Always have reliable, affordable childcare OR do not need childcare.

2 - Rely on subsidized childcare.

1 - Need childcare but none available or cannot afford.

EDUCATION(Required)

3 - Completed a post-secondary training or educational program.

2 - Enrolled in high school or equivalent program.

1 - Did not complete high school.

DIGITAL LITERACY AND ACCESS(Required)

3 - Proficient at using computers, tablets, and smart phones; have high-speed access.

2 - Limited ability to use computers, tablets, and smart phones OR have limited access.

1 - Do not understand how to use computers, etc., or choose not to use or do not have access.

FINANCIAL LITERACY(Required)

3 - Understand AND benefit from modern banking, credit, and investment systems.

2 - Limited understanding of modern banking, credit, and investment systems.

1 - No knowledge of modern banking, credit, and investment systems.

CIVIL OR CRIMINAL LEGAL ISSUES(Required)

Consider probation, parole, child protective services, child support, divorce, traffic tickets, contract disputes, etc.

3 - No criminal history or outstanding civil matters.

2 - On probation for misdemeanors OR have pending child support case or other minor legal issue.

1 - Have outstanding warrants, a pending CPS case, or some other serious unresolved legal issue.

HEALTHCARE(Required)

3 - All family members have access to affordable health care.

2 - Some family members have access to affordable care.

1 - No access to any healthcare except the emergency room.

SUPPORT STRUCTURE(Required)

3 - Strong and healthy support from expanded network of family or friends.

2 - Occassional support from family or friends but often limited.

1 - No support from family or friends OR relationships are abusive or unhealthy.

MOBILITY(Required)

Includes issues such as mechanical condition of vehicles, driver's license, and adequate insurance.

3 - Public or private transportation is always available to meet essential travel needs.

2 - Public or private transportation is available but limited for various reasons.

1 - No access to public or private transportation.

COMMUNITY INVOLVEMENT(Required)

Include volunteer work, school organizations/meetings, sports, etc.

3 - Actively involved in one or more communities of people.

2 - Limited involvement and/or unsure how to get involved.

1 - No involvement in any community.

MONEY MANAGEMENT(Required)

3 - Rent and other bills are always paid on time.

2 - Must choose which bills to pay on time and which to pay late.

1 - Rent and other bills are always paid late.

SAVINGS(Required)

3 - Save money regularly; make only necessary withdrawals.

2 - Occassionally save money.

1 - Do not save money.

CREDIT(Required)

3 - No negative credit; low debt-to-income ratio.

2 - No credit history OR credit score close to 580.

1 - All credit is negative; high debt-to-income ratio.

EXERCISE & OUTDOOR ACTIVITIES(Required)

3 - Exercise regularly and spend some time outside almost every day.

2 - Exercise and/or engage in physical activity outside 2 – 3 times per week.

1 - Rarely set aside time to exercise and/or engage in physical activity.

NUTRITION(Required)

3 - Most of the time I prepare balanced meals from scratch using high-quality, basic foods.

2 - Occasionally eat nutritious, balanced meals at home or dining out.

1 - Most meals are fast food and/or are highly processed, pre-packaged foods.

COMMENTS OR ADDITIONAL INFORMATION

YOUR GRADE:

We will do the math but if you want to do it yourself, add up the numbers of each selection, divide by 51, and enter the result below.

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FAMILY SELF-SUFFICIENCY ANALYSIS

Select the most appropriate response in each of the following areas.

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