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The Arc Jacksonville Village Interest Questionnaire

Contact Information

Please note: After completing the information on this page, you will have the option to to save your survey progress and complete it at a later date. This option will be located at the top of the survey. 
1. Please complete the following contact information: *This question is required.
2. Gender of interested resident? *This question is required.
4. The person completing this survey is: *This question is required.
5. I understand that the information I will be asked to provide does not constitute a rental application, nor does it guarantee residency at The Arc Jacksonville Village. The information will be used for programmatic planning and to assess the supports needed.

I understand that the information provided will be kept on file to be used in conjunction with the formal application process which will occur at a later date.

I understand the information provided will be kept confidential.