Briar Hill Community Engagement

The agencies working in Briar Hill would like to know what residents think about their area and what they would like to see in the future. We would very much appreciate it if you would take a few minutes to complete this short questionnaire. There is an opportunity to leave your contact details if you would like someone to contact you. Otherwise your answers will be anonymous.

Thank you very much for your time.

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* 1. Please give your postcode

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* 2. What do you like about your area?

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* 3. What don't you like about your area?

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* 4. What would you like to see in your area?

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* 5. What would you like to see happen in the new community space when it is open?

Youth Club

Meeting space

Mums & tots groups

Sports/exercise activities

Drop in sessions for Housing Officer/Police/other agencies

Other (please specify)

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* 6. If you would like someone to contact you, please state which agency and leave your name and either an email address or telephone number.

Name

Agency I would like to contact me is:

Email Address

Phone Number

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* 7. The age group I fit into is:-

under 12 years

13 to 18 years

19 - 30 years old

31 - 65 years old

over 65 years old

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* 8. My faith is....

Christian

Muslim

Jewish

Hindhu

Buddhist

Sikh

No religion

Prefer not to say

Other (please specify)

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* 9. My ethnicity is

White British

White non British

Asian / Asian British

Black / Black British

Chinese

Mixed Background

prefer not to say

Other (please specify)