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* 1. Name (Optional)

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* 3. Are you a member of:

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* 5. Which Health Trust do you belong to?

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* 6. Please indicate by ticking which/if any of these apply to you.

Please note that we do not share this information; it simply supports us to tailor service delivery for our members and to advocate on your behalf.

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* 7. What support would you like to receive in order to achieve employment?

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* 8. Are you aware of our Women Breaking Barriers Programme?

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* 9. If you have participated in a Women Breaking Barriers course, what has been your experience of having a programme like this delivered in a rural area?

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* 10. Did you know if you belong to a women's group our Engagement Officer can meet with you to discuss training, funding, Covid recovery support etc?

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* 11. Would you like to meet with our Engagement Officer to discuss your group's specific needs?

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* 12. In general, how would you rate your overall mental and emotional health?

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* 13. During the past 6 months, how supported did you feel when you wanted or needed help from others?  E.g.  if you felt lonely and wanted to talk to someone or you needed help with a particular activity.

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* 14. If you have participated in NIRWN workshops, events or activities in the past how do you feel they have they benefitted you? (tick all that apply)

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* 15. Do you receive NIRWN's monthly Ezine NIRWN News?

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* 16. If yes do you find the Ezine content:

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* 17. NIRWN has increased it's online and social media presence over the past two years.  
Please tick if in the last year you have:

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* 18. Are you aware that NIRWN is a partner in the Raise Your Voice Campaign against sexual harassment and offer free workshops?  www.raiseyourvoice.community

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* 19. Are you aware that we have a free tablet loan scheme (Rural Reach Project) for our members/member groups?

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* 20. Have you participated in any NIRWN events, training or activities in the past year?

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* 21. In this Covid Recovery Phase how comfortable are you participating in NIRWN activities in a physical space?

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* 22. Below are the main policy issues of concern previously identified by our membership.  What do you consider to be the main issues of concern to you, your family or your community at present?  Tick all that apply

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* 23. As a regional organisation, NIRWN's mission is to advance the participation and recognition of rural women.  Are there additional services, training, activities that you would like NIRWN to support you with?

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* 24. Please share with us any additional feedback or comments you have.

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