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Commission on the Status of Women (CSW) -
"20-Minute Community Feedback Survey"

Please note that this Survey is CONFIDENTIAL but not anonymous; your contact information is needed to assure the validity of the results.

Name: *

Organization: *

Email: *

Phone: *

(Example: 818-240-4844)

Age: *

15-24
25-34
35-44
45-54
55-64
65+

Gender: *

Male
Female
Decline to state

Ethnic Group: *

White
Black
Hispanic
Asian or Pacific Islander
Armenian
American Indian or Alaskan Native
Filipino

Other
Decline to state

* = Required Fields

Survey: PART ONE

Are you aware of the City of Glendale Commission on the Status of Women ?

Yes
No
Vaguely

Have you ever attended a CSW event?

Yes
No

If you have, which event?

If so, how satisfied were you with the event?

Very
Somewhat
Not at all

Do you watch GTV6?

Yes
No

Have you ever viewed a televised meeting of the CSW?

Yes
No

Which of the following issues are of particular interest to you? If services or education was available in the city in these areas, which would you use? Check all that apply.

Healthcare Education
Affordable, Quality Child Care
Affordable Before/After School Care
Help/Education about Handling Your Money
Help/Education about How to Start Your Own Business
Political/Legislative Issues of Interest to Women
Sports and Fitness Training for Girls
Career/Vocational Training in Non-Traditional Careers for Women and Girls
Women and Academia
Education and Assistance for Affordable Housing
Domestic Violence Prevention and Awareness Education
Domestic Violence Assistance
Human Trafficking
Global Women's Issues - Women and War, Micro Economics, etc.
Women's History
Women and Prison
Women and Technology
Volunteer Opportunities

Based on the above list, rank your top 5 services/issues.

1 -
2 -
3 -
4 -
5 -

Survey: PART TWO

For the following questions, please respond as completely as possible.

Do you attend any other city functions (i.e. Snow Day at Brand Library, Week of Remembrance Activities, Cesar Chavez Celebration, Cruise Night, Unity Fest, etc)?

What types of programs would you like to attend?

What times/days of the week would you be most likely to attend a Commission event?

What needs of women and girls would you like to see addressed? In what ways?

Any other feedback/input you would like to share with the CSW?

What times/days of the week would you be least likely to attend an event?
Why (child care needs, other obligations, etc) ?

How did you find out about this survey?

City website
Direct mailing
Email
Other

THANK YOU FOR YOUR TIME!

Last modified: Wednesday, February 08, 2012 4:14:30 PM

Commission on the Status of Women (CSW) -"20-Minute Community Feedback Survey"

Commission on the Status of Women (CSW) -
"20-Minute Community Feedback Survey"