SURVEY FORM
If you live in a dangerous habitat, please complete this form:
In which kind of habitat do you live?
Select one River flood plain Earthquake zone Near an active volcano In an area of wind storms On a steep slope
Why did you decide to live here? (you may choose more than one)
I could find no other place I could afford no other place I like living dangerously It is the most pleasant part of town Another reason
Yes No
I cannot afford to move I have lived here all my life I live near my work I love this community Another reason