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* 1. I identify my gender as (please select one)

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* 2. What is your age?

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* 3. Which Town do you live in?

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* 4. Are you a young person with a disability?

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* 5. Please indicate which Council activities/ programmes/ groups you are aware of in the Northern Midlands:

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* 6. Do you have any suggestions for other youth activities, programmes or groups that you would like to see in the Northern Midlands area?

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* 7. How important is your health and wellbeing to you (i.e feeling happy, being healthy, having friends, having supportive family etc.)?

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* 8. What issues are the most important to you (please select 1 or more)

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* 9. What do you think are the three most important issues facing other young people living in the Northern Midlands Municipal area?

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* 10. How can Council better support young people to address these issues?

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* 11. What would YOU like to see improved in our community?

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* 12. What can Council do to work better/engage with young people to ensure that they have a voice in our community?

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* 13. Have you attended one of these sessions or been involved in one of these programs? (please select)

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