Choteau Community Survey Q1. Listed below are public services and community amenities. Thinking about availability, cost, quality, and any other considerations important to you, how satisfied or dissatisfied are you with the following aspects of your community? Please circle a number from 1 (highly dissatisfied) to 5 (highly satisfied), or “don’t know.” Highly dissatisfied 1 2

3

Highly satisfied 4 5

2

3

4

5

DK DK

1

2

3

4

5

DK

Parks & playgrounds

1

2

3

4

5

DK

e.

Bicycle & pedestrian access

1

2

3

4

5

DK

f.

Condition of streets & roads

1

2

3

4

5

DK

g.

Public transportation

1

2

3

4

5

DK

h.

Internet service

1

2

3

4

5

DK

i.

Appearance of downtown

1

2

3

4

5

DK

j.

Appearance of neighborhoods

1

2

3

4

5

DK

k.

Police protection/law enforcement

1

2

3

4

5

DK

l.

Medical care services

1

2

3

4

5

DK

m.

Mental health services

1

2

3

4

5

DK

n.

Senior citizen support services

1

2

3

4

5

DK

o.

Available jobs

1

2

3

4

5

DK

p.

Pay rates (salaries/wages)

1

2

3

4

5

DK

q.

Access to higher education (e.g., college, technical)

1

2

3

4

5

DK

r.

Variety of goods & services available

1

2

3

4

5

DK

s.

Responsiveness of local government

1

2

3

4

5

DK

t.

Civic & nonprofit organizations

1

2

3

4

5

DK

u.

Arts, entertainment, & cultural activities

1

2

3

4

5

DK

v.

Friendliness of residents

1

2

3

4

5

DK

w.

Availability of fresh fruits & vegetables

1

2

3

4

5

DK

x.

Recreation/entertainment opportunities

1

2

3

4

5

DK

y.

Variety of industry

1

2

3

4

5

DK

a.

Local K-12 school system

b.

Childcare/early childhood education programs

1

c.

Housing

d.

Don’t know

Q2. Would you like to comment or explain why you rated your satisfaction with any of these public services and community amenities in the way you did? If so, please provide your comments/explanation here:

Q3. Would you like to comment on your level of satisfaction with any other public services or community amenities that are not listed above? If so, please explain here:

Q4. In general, how effective do you think the residents of your community are at working together to solve challenges?

o

Very effective

o

Somewhat effective

o

Not at all effective

Q5. Please briefly explain why you answered the previous question (Q4) in the way you did:

Q6. Have you been involved in a neighborhood or community project in the last 12 months? For example, youth development, community beautification, fund raiser, etc.

o o

Yes No If yes, please tell us the type(s) of projects you have been involved in:

Q7. Please complete this sentence: “I would be involved in more community projects if…”

Q8. Do any of the following factors challenge your ability to support Choteau’s locally owned businesses? Please select all that apply.

□ □ □ □ □ □

Prices Hours of operation Parking Availability of products, services, or both Nothing/no challenges Other challenge(s)—please specify: _______________________________________________________________

Q9. To what extent do you agree or disagree with the following statement: “Choteau is a good place to raise a family”?

o

o

Strongly agree

o

Somewhat agree

Somewhat disagree

o

Strongly disagree

Q10. How important or unimportant is encouraging tourism in the area?

o

o

Very important

Somewhat important

o

Somewhat unimportant

o

Very unimportant

Q11. What is your sex?

o Male

o Female

o Prefer not to answer

Q12. What is your race? Please select all that apply.



African American/Black



American Indian/Alaska Native



Asian/Pacific Islander



White



Q13. What is your ethnicity?

o Hispanic

o Non-Hispanic

Q14. In what year were you born? ____________ birth year Q15. What is your annual household income?

o Under $25,000

o $25,000-$49,999 o $50,000-$74,999 o $75,000-$100,000 o Above $100,000

Q16. Do you live within or outside the Choteau city limits?

o Within city limits

o Outside city limits

Q17. How many years have you lived in Choteau or the immediate area?

o 0-5 years

o 6-10 years

o 11-20 years

o More than 20 years

Other

Predicting Seniors' Quality of Life in the Intermountain -

Mental health services. 1. 2. 3. 4. 5. DK n. Senior citizen support services. 1. 2. 3. 4. 5. DK o. Available jobs. 1. 2. 3. 4. 5. DK p. Pay rates (salaries/wages). 1. 2. 3.

490KB Sizes 1 Downloads 220 Views

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