triangle logoChildren’s Centre Satisfaction Survey

1. Do you have any children under the age of 5? Please Select:  Yes      No
2. What is your post code?
3. Are you male or female? Please Select:  Male      Female
4. Are you a lone parent? Please Select:    Yes      No
5. Do you have a disability? Please Select:    Yes      No
6. Do you have a disabled child under 5? Please Select:    Yes      No
7. Which age range are you in?
8. Please select which ethnicity applies to you:

9. Have you heard about Children’s Centres? Please Select:  Yes      No
   
10. How would you like to receive information about Children’s Centres? Please tick all that apply to you:
  Internet/email
Text
Post
Telephone
Poster/leafl et
Face to face
Audio CD
Visual DVD
Braille
Other
No opinion

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