FREE PRIZE DRAW 1st Prize £30 vouchers 2nd Prize £20 vouchers WHAT DO YOU THINK? What do YOU want to see in your community? Please take a few minutes to fill in this questionnaire 1. Would you like to see more happening locally? Yes No Ok as it is If yes, what would you like to see? For example social events, arts, sporting activities, learning and courses ………………………………………………………………………………………………..…………………………………………………………………………………………………….. 2. If you want to learn something specific what is it? ………………………………………………………………………………………………….………………………………………………………………………………………………….. 3. Where would you like activities to take place? For example in the schools, other local venues ……………………………………………………………………………………………………………………………………………………………………………………………………. 4. When would you like activities to take place? Morning Afternoon Evening Weekends 5. Would you be prepared to pay to participate? Yes No Would only attend if free 6. Would you need help with transport? Yes No 7. Would you need childcare to be provided? Yes No 8. Is there any support you need as a parent? For example parenting skills, help to support your child through education, attending homework clubs or family learning. ………………………………………………………………………………………………………………………………………………………………………………………………….... 9. Would you like to be able to access services such as health and social services more locally for you and your family? Yes No Unsure Detail any services that would be helpful to you ……………………………………………………………………………………………………………………………………………………………………………………………………. 10. What type of child-care would be beneficial to you (if appropriate)? For example before school, after school, school holiday clubs, child-minders (child-care provision would not be available free of charge) ……………………………………………………………………………………………………………………………………………………………………………………………………. 11. Anything else we need to consider? Any other comments you would like to make? ……………………………………………………………………………………………………………………………………………………………………………………………………. …………………………………………………………………………………………………. 12. Would you like to become involved in organising any activities or volunteering your time? Yes No Unsure Can we contact you at a later date? Yes No 13. Please give us your details so we can enter you into the free prize draw Name ……………………………………………………………………………… Address …………………………………………………………………………………………………………………………………………………………………………………………………….. Telephone Number ……………………………………………………. Many thanks for taking the time to fill in this questionnaire.
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