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调研问卷模板英文版.doc

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1、Helpful hints for completing this questionnaire The questionnaire should be completed by any resident aged 18 or over living at this address. Please read each question carefully and tick a box to indicate your answer. In most cases you will only have to tick one box but please read the questions car

2、efully as sometimes you will need to tick more than one box. Answer the next question unless asked otherwise. Once you have finished please take a minute to check you have answered all the questions that you should have answered. The survey consists of 7 pages and should take no longer than 10 minut

3、es to complete. If you have any queries about the questionnaire please do not hesitate to contact Miller Associates on 023 8081 2329 Once you have completed the questionnaire please return in the pre-addressed envelope supplied by 24 September 2008. You do not need to add a stamp If you cannot find

4、or did not receive the pre-addressed envelope please send to Miller Associates, Freepost (S) 4120), TOTTON, Southampton, SO40 7EW (you do not need to add a stamp) or call 023 8081 232911. Thinking generally, which of the things below would you say are most important in making somewhere a good place

5、to live? Pick tick up to FIVE boxes only in the left column below2. And thinking about your local neighbourhood (within 15-20 minutes walking distance of where you live), which of the things below, if any, do you think most need improving? Please tick up to FIVE boxes in the right column belowMost i

6、mportant in making somewhere a good place to liveMost needs improvingin this local areaAccess to natureActivities for teenagersAffordable decent housingClean streetCommunity activitiesCultural facilities (for example cinema, theatres, museums)Education provisionFacilities for young childrenHealth se

7、rvicesJob prospectsThe level of crimeThe level of pollutionThe level of traffic congestionParks and open spacesPublic transportRace relationsRoad and pavement repairsShopping facilitiesSports and leisure facilitiesWage levels and local cost of livingOther (WRITE IN BELOWNone of theseDont know3. Over

8、all, how satisfied or dissatisfied are you with this neighbourhood as a place to live? Please tick one box onlyVery satisfiedFairly satisfiedNeither satisfied nor dissatisfiedFairly dissatisfiedVery dissatisfied4. How strongly do you feel you belong to your local neighbourhood? Please tick one box o

9、nlyVery stronglyFairly stronglyNot very stronglyNot at all strongly5. Would you say your local neighbourhood is a place you enjoy living in? Please tick one box onlyYes definitelyYes, to some extentNo26a. To what extent do you agree or disagree that your local neighbourhood is a safe place to live?

10、Please tick one box onlyb. To what extent do you agree or disagree that Basingstoke town centre is a safe place? Please tick one box onlyc. To what extent do you agree or disagree that other parts of the borough are safe places generally? Please tick one box onlyLocal NeighbourhoodTown Centre Other

11、parts of the boroughDefinitely agreeTend to agreeTend to disagreeDefinitely disagreeDont know7. Thinking about your local neighbourhood, how much of a problem do you think are. Please tick one box per rowA very big problemA fairly big problemNot a very big problemNot a problem at allDont knowParents

12、 not taking responsibility for the behaviour of their childrenPeople not treating other people with respect and considerationNoisy neighbours or loud partiesTeenagers hanging around the streetsRubbish and litter lying aroundPeople being drunk or rowdy in public placesAbandoned or burnt out carsVanda

13、lism, graffiti or other deliberate damage to property or vehiclesPeople using or dealing drugs8. Generally how safe do you feel in the following situations? Please tick one box per rowVery safe Fairly safe Neither Fairly unsafe Very unsafeInside your home during the dayInside your home during the ni

14、ghtOutside your home during the dayOutside your home during the night9. If you do not feel safe in any of these situations, why do you say this? Please write in below310. Most of us worry at some time or other about being a victim of crime. How worried are you about each of the following.? Please ti

15、ck one box per rowVery worriedFairly worriedNot very worriedNot at all worriedDont knowHaving your home broken into and something stolenBeing mugged and robbedBeing physically attacked by strangersBeing insulted or pestered by anybody, while in the street or any other public placeBeing subject to a

16、physical attack because of your skin colour, ethnic origin or religionIn general, becoming a victim of any type of crime 11a. Of the following, who do you think contributes significantly to improving the safety of living in this area? Please tick as many as applyb. And who do you think makes the pri

17、me contribution to improving the safety of living in this area? Please tick one box only11a Tick asMany as apply11b Tick one onlyLocal residentsNeighbourhood WatchThe Police (Police Beat Officer)The Police (Community Support Officer)The Borough Council (Community Warden)The County Council (ACSO)The

18、Fire ServiceThe Health ServiceHousing AssociationsOther (Please specify)12a. In order for patrols in this area to be most effective in tackling crime (e.g. burglary, assault), which of the following do you feel it is most important for them to have? Tick as many as apply12b. In order for patrols in

19、this area to be most effective tin tackling anti social behaviour (e.g. groups on the streets, vandalism, noise), which of the following do you think it is most important for them to have? Tick as many as apply12c. And which two do you think it is most important to have? Please tick two only12a Tick

20、 as many as apply12b Tick as many as apply12c Tick two onlyKnowledge and understanding of the local areaThe skills to support vulnerable people, particularly the elderlyObservational skills so crime and anti-social behaviour can be reportedThe skills to work with and engage with young peopleAbility

21、to support the work of police officers in a range of dutiesPowers to issue fixed penalty notices in relation to a range of anti-social behavioursPowers to detain a suspect until the police arriveCapacity to set up community groups and activitiesA visible presence on the streetsSkills to help support

22、 victims of crimeTalks to local schools/community groupsOther (Specify)413. To what extent do you agree or disagree that your local neighbourhood is a place where people from different backgrounds get on well together? Please tick one box onlyDefinitely agreeTend to agreeTend to disagreeDefinitely d

23、isagreeDont knowToo few people in local areaAll the same background14. To what extent do you agree or disagree that the following groups in your local neighbourhood are able to get the services and support they need? Please tick one box per rowDefinitely agreeTend to agreeTend to disagreeDefinitely

24、disagreeDont know/not sureChildren up to 11 years oldYoung people between 11 and 18Older peopleBlack/Minority Ethnic groupsPeople who are less well offPeople with disabilitiesGay/lesbians/bi-sexual/ transexualPeople of different religions15. To what extent do you agree or disagree with each of the f

25、ollowing? Please tick one box per rowDefinitely agreeTend to agreeTend to disagreeDefinitely disagreeDont know/not surePeople in this neighbourhood pull together to improve the neighbourhoodPeople in this neighbourhood are willing to help their neighboursThis is a close knit neighbourhood16. Thinkin

26、g about your local community facilities (e.g. village hall, community centre), how satisfied are you with each of the following? Please tick one box per rowVery satisfiedFairly satisfiedNeither Fairly dissatisfiedVery dissatisfiedDont knowNot applicableThe building itselfAccess to the facilityThe pr

27、ogramme of activities that take place thereInformation about what goes on thereThe role it plays as a focus for the community517. In the last twelve months have you given unpaid help to any groups, clubs or organisations in any of the following ways? Please tick as many as applyRaising or handling m

28、oney/taking part in sponsored eventsLeading the group/member of a committeeOrganising or helping to run an activity or eventVisiting peopleBefriending or mentoring peopleGiving advice/information/counsellingSecretarial, admin or clerical workProviding transport/drivingRepresentingCampaigningOther pr

29、actical help (helping out at school, shopping)Any other help18. To what extent do you agree or disagree that you can influence decisions affecting your local neighbourhood (within 15 to 20 minutes walking distance)? Please tick one box onlyDefinitely agreeTend to agreeTend to disagreeDefinitely disa

30、gree19. If you want to change something in your local neighbourhood or have an idea about making the area a better place to live in, what are you most likely to do about it? Please tick one box onlyTake direct actionTalk about it amongst local friends and decide what to doApproach community/resident

31、 organisations/groups about itApproach a local representative for example a borough or parish councillorOther (please write in below)20. In the last twelve months have you? Please tick as many as applyBeen a local councillor (for the local authority, town or parish)Member of parish planning groupMem

32、ber of a group making decisions on local health services (e.g. patient forums)Member of a decision making group set up to regenerate the area (e.g. local residents group)Member of a decision making group set up to tackle local crime problems (e.g. Neighbourhood Watch)Member of a tenants group decisi

33、on making committeeMember of a group making decisions on local education services (e.g. school governor)Member of a group making decisions on local services for young people (e.g. youth club or church)Member of another group making decisions on services in the local community (Please write in below)

34、21. And in the last twelve months have you taken part in a consultation about local services or problems in your area in any of the following ways? Please tick as many as applyCompleting a questionnaire (about local services and problems in the local area) please do not include this questionnaireAtt

35、ending a public meeting (about local services or problems in the local area)Being involved in a group set up to discuss local services or problems in the local areaNone of the above622. How well informed do you feel about each of the following? Please tick one box per rowVery well informedFairly wel

36、l informedNot very well informedNot well informed at allDont knowHow and where to register to voteHow you can get involved in local decision makingWhat the council and police are doing to tackle anti-social behaviour in the areaWhat the council and police are doing to tackle crime in the neighbourho

37、odWhat is going on in local community facilities in your local neighbourhoodOther things going on in your local neighbourhoodWhat is going on in the borough as a wholeOverall, how well informed do you think you council keeps residents about the services and benefits it provides23. Are you male or fe

38、male? Please tick one box only MaleFemale24. What was your age on your last birthday? Please write in below25. How long have your household been living in their current accommodation? Please tick one box onlyUnder 1 year 11-20 years1-2 years 21+ years3-5 years Dont know/cant remember6-10 years26. Ho

39、w long have you/your household been living in this area?Under 1 year 11-20 years1-2 years 21+ years3-5 years Dont know/cant remember6-10 years27. In which of these ways does your household occupy your current accommodation?Owned outright Rent from Housing Association/TrustBuying on mortgage Rented f

40、rom private landlordRent from council Other (tick and write in below)28. Which of the following do you regard as your local neighbourhood? Please tick one box onlyThe whole of the borough of Basingstoke and Deane The whole town or villageThe whole parish or wardYour local housing estate or neighbour

41、hoodYour streetDont know/not sure729. How many adults aged 18 or over are living here? Please tick one box onlyOne FourTwo FiveThree More than five (Tick and write in number below)30. Which of these activities best describes what you are doing at present? Please tick one box onlyEmployee in full-tim

42、e job (30 hours plus per week)Employee in part-time job (under 30 hours per week)Self employed full or part-timeOn a government supported training scheme (e.g. Modern Apprenticeship/Training for Work)Full-time education at school, college or universityUnemployed and available for workPermanently sic

43、k/disabledWholly retired from workLooking after the homeDoing something else (Tick and write in below)31. Do you have any long-standing illness, disability or infirmity? (Long standing illness means anything that has troubled you over a period of time or that is likely to affect you over a period of

44、 time) Please tick one box onlyYes (Please continue to Q30)No (Please go to Q31)32. Does this illness or disability limit your activities in any way? Please tick one box onlyYesNo33. To which of these groups do you consider you belong? Please tick one onlyWhite Black or Black BritishBritish Caribbea

45、nIrish AfricanAny other White background Any other Black backgroundMixed AsianWhite and Black Caribbean IndianWhite and Black African PakistaniWhite and Asian BangladeshiAny other Mixed background Any other Asian backgroundChinese and Other Ethnic groupsChineseOther ethnic group34. Which of the foll

46、owing areas of the borough do you live in? Please tick one onlyCentral BasingstokeOuter part of BasingstokeLarge villageSmall villageTown (other than Basingstoke)Other35. Please write in your postcode below?836. Do you have any other comments to make about the content of this questionnaire or your l

47、ocal neighbourhood? Please write in below37. Would you be interested in signing up to become involved in future consultations about local decisions and services? This would involve completing questionnaires sent to you by post about three or four times a year as part of a residents panel. If so, ple

48、ase provide the following information.(PLEASE NOTE: For prize draw entry there is no need to provide your name and address as the unique identifier on this questionnaire allows us to link it to the address of the person completing the questionnaire this is the only way in which we link the questionn

49、aire to your address. You only need to give us your contact details if you wish to sign up for the residents panel.)Title: Mr/Mrs/Ms/OtherFirst name _Surname _Address _Postcode _E-mail _Daytime telephone number _In complying with the Data Protection Act 1998 Basingstoke and Deane Borough Council confirms that it will proces

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