Consultation Questionnaire

Please help us to gather information which will help us to improve our Community Centre and Social Club. This survey is made of 10 simple questions and should take about 3 minutes to complete.

You will not be asked to give your name or contact details, and you need not answer every question. Though we do require everyone completing the survey to answer questions 1, 2 and 4.

We understand that some respondents may not wish to complete questions 7 to 10, but it would help us if you can provide this information. 

Thank you! 

Catholic Parish of St Mary and St Thomas More, Cannock. 
Birmingham Diocesan Trust: Reg Charity No. 234216

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* 1. Do you use St Mary's Community Centre and Social Club, Cannock?

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* 2. What would encourage you to make more use of the Centre and the Club? (tick as many as you like)

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* 3. What Services or Activities would you like to see available at the Community Centre? (Tick as many as you like)

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* 4. What are the three main things that concern you about where you live? (Please choose no more than three)

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* 5. What time of the day would you prefer to access services at Centre?

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* 6. Please add further comments below.

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* 7. (optional) What is your gender? 

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* 8. (optional) What is your age?

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* 9. (optional) Would you consider yourself to have a disability?

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* 10. (optional) How would you describe your Ethnic Background or Origin? 

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