age |
Applicants age |
age range |
Applicants age range |
agency |
I feel agency over my future. |
amount of energy |
In the last month, how would you describe the amount of energy you have to engage in your artistic or cultural practice(s)? Please consider your overall physical, mental, emotional, and creative energy |
amount of time |
In the last month, how would you describe the amount of time you have to engage in your artistic or cultural practice(s)? |
approach to practice |
How do you approach your practice as an artist, culture bearer, or culture maker? Select all that apply |
art practice impact |
How, if at all, was your artistic practice impacted between March 2020 and February 2022? Select all that apply: |
articulating involved |
Do you feel confident articulating your creative process and the labor involved? |
aware of gi |
Prior to learning about Creatives Rebuild New York, were you aware of guaranteed income or universal basic income policies? |
caregiver |
Do you regularly provide care – either on your own or with someone else – to any of the following people? Select all that apply: |
carrying debt |
Are you currently carrying debt? This could include financial obligations not paid in full each month like credit cards, personal loans, payday loans or short-term debt, student loan debt, housing debt, automobile loan, other. |
coalitions |
Which coalitions or causes do you actively participate in as a supporter or advocate? Select all that apply: |
community |
How would you describe the community in which you live? [Select one] |
county |
County |
criminal legal |
Do you have any past criminal legal system involvement? [Select one] |
deaf disabled |
Do you identify as Deaf or disabled? [Select one] |
debt manageability |
If yes, would do you describe it as: |
deserve safety net |
Do you believe that artists, culture bearers, and culture makers deserve to have a financial safety net? (A “financial safety net” is a personal financial cushion that can include emergency savings funds, assets, family resources, disability insurance coverage, and life insurance so that one can financially support themselves for 3-6 months without income and/or in the case of an emergency.) |
discipline |
Please rank up to three discipline(s) that best reflect your practice as an artist, culture bearer, or culture maker |
emergency assistance |
If yes, which of the following types of emergency financial assistance did you
receive? Select all that apply: |
emergency assistance received |
At any time between March 2020 and February 2022, did you receive any kind of emergency financial assistance? [Select one] |
emergency money |
If an unexpected $400 emergency came up today, would you be able to pay for it with cash or a cash equivalent, without using credit? |
employ impact |
How, if at all, was your employment impacted between March 2020 and February 2022? |
experience barriers |
Do you experience any barriers to pursuing educational or professional development
opportunities that advance your artistic or cultural practice? |
feed myself |
I am able to feed myself and those I care for. |
financial capacity |
In the last month, how would you describe your financial capacity to afford to engage in your artistic or cultural practice(s)? Please consider necessary materials, training, space, assistance, or other needs related to your artistic or cultural practice(s). |
financial stability |
On a scale of 1-5, how would you describe your own financial stability? |
gender |
What is your gender identity? |
health insurance |
Do you currently have health insurance? |
household income |
Please provide an estimate of your 2021 household income, before taxes: |
immigrant |
Do you identify as an immigrant to the U.S.? [Select one] |
language |
What is your primary spoken language? [Select one] |
LGBTQIAP |
Do you identify as LGBTQIAP+ (lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual/aromantic, pansexual)? [Select one] |
mental health |
I am in good mental and emotional health. |
money source |
How do you currently earn money? Select all that apply |
optimistic about future |
I am optimistic about the future |
other income |
Do you have any other sources of income or financial stability besides income from jobs? Please consider sources such as inheritances, real estate, family support, retirement accounts, stocks, bonds, tangible property, settlements, or lottery proceedings. [Select one.] |
physical health |
I am in good physical health. |
policy group member |
Are you an active member of any group (not including a political party) that tries to influence public policy or government? |
public values |
Do you feel that the general public values, sees, and/or understands your work? |
purposeful life |
I lead a purposeful and meaningful life. |
race |
Which of the following best describes you? Select all that apply: |
region |
Region |
seek impacts |
In your artistic or cultural practice, do you seek specific impacts or outcomes related to community change? |
selected |
Selected to be in the guaranteed income program |
social relationships |
My social relationships are supportive and rewarding. |
stable housing |
My housing circumstances are stable and meet my needs. |
transgender |
Do you identify as transgender? [Select one] |
wage paid source |
. How are your wages currently paid? [Select one] |
wellbeing impact |
How, if at all, was your well-being impacted between March 2020 and February 2022? Select all that apply: |
zipcode |
Zip Code |