Survey"*" indicates required fieldsName * Required First Last 1. Who are you in the life of this child(ren)? * RequiredGrandparentAunt/UncleSiblingNon-RelativeOther Relative2. What’s your age? * Required18-2425-3435-4445-5455-6465 or Above3. How long have you been caring for the children currently in your care? * RequiredLess than a month1-3 months4-6 months7-12 monthsMore than a year4. How many kinship children are you caring for?0123456+Please mark the age ranges of the children you are caring for. 0-2 3-5 6-12 13-17Hidden4. What ages are the kids you’re caring for? Please select all that applyHidden0-2 years old0123456+Hidden3-5 years old0123456+Hidden6-12 years old0123456+Hidden13-17 years old0123456+5. What are your greatest needs? Legal Financial Mental Health and Support Child Behavior Parenting Information Education Physical Health Basic Needs (food, clothing, shelter, etc.) Transportation Dental Health Child Care OtherWhat are your other needs?6. Which county are you living in? * RequiredAdams CountyBarnes CountyBenson CountyBillings CountyBottineau CountyBowman CountyBurke CountyBurleigh CountyCass CountyCavalier CountyDickey CountyDivide CountyDunn CountyEddy CountyEmmons CountyFoster CountyGolden Valley CountyGrand Forks CountyGrant CountyGriggs CountyHettinger CountyKidder CountyLaMoure CountyLogan CountyMcHenry CountyMcIntosh CountyMcKenzie CountyMcLean CountyMercer CountyMorton CountyMountrail CountyNelson CountyOliver CountyPembina CountyPierce CountyRamsey CountyRansom CountyRenville CountyRichland CountyRolette CountySargent CountySheridan CountySioux CountySlope CountyStark CountySteele CountyStutsman CountyTowner CountyTraill CountyWalsh CountyWard CountyWells CountyWilliams County7. Would you like a Kinship Navigator to contact you about the Kinship-ND program and how it may assist you as a caregiver? Yes NoEmail addressPhone numberCAPTCHAPhoneThis field is for validation purposes and should be left unchanged.Δ
