FAMILY RESOURCE SURVEY Date_________________
Family name_______________________________________________________________________
Address____________________________________________________________________________
Home telephone____________________________________________________________________
Work telephones___________________________________________________________________
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Drives |
Cell phone |
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Equipment |
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___construction equipment |
___camp stove |
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___hand tools |
___Dutch oven how many: sizes: |
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___truck kind: |
___solar oven |
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___4-wheel drive vehicle kind: |
___alternate heat source |
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___RV kind: |
___wood burning fireplace |
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___tow truck |
___log splitter |
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___trailer size: |
___72 hour kits how many: |
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___boat size: |
___auto emergency kit |
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___snow blower |
___rototiller size: |
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___generator size: |
___yard tractor |
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___swimming pool |
___gardening tools |
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___chain saw |
___greenhouse |
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___extra saw chains |
___freezer size: |
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___CB radio |
___dehydrator |
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___ham radio |
___water bath canner |
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___walkie talkies |
___pressure canner |
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___fishing equipment |
___other canning equipment: |
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___hunting rifle |
___sewing machine |
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___tent size: |
___serger |
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Skills |
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___nurse |
___carpentry |
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___doctor |
___plumbing |
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___dentist |
___electrical |
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___trained EMT |
___hunting |
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___CPR trained |
___fishing |
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___counselor |
___butchering |
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___lawyer |
___gardening |
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___heavy equipment operator |
___canning |
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___ham radio operator |
___sewing |
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Living storage |
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___animals kind: |
___nut trees number: kind: |
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___fish kind: |
___berries kind: |
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___poultry kind: |
___grapes |
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___garden size: |
___spring-fed well |
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___fruit trees number: kind: |
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Home storage |
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___food how much: |
___library |
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___water how much: |
___seeds for planting |
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___medical supplies |
___root cellar |
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___extra clothing |
___basement what kind: |
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___sewing supplies |
___emergency savings |
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___emergency fuel supplies |
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Special Needs: