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Getting to know you Chinchilla
We invite you to spend 15-20 minutes completing this survey.
We want to know more about our Chinchilla community. We will use this information to advocate for improved services and supports.
Introducing you
1.
What is your gender?
Female
Male
Other (please specify)
*
2.
What is your age range?
(Required.)
Under 18
18-24
25-34
35-44
45-54
55-64
65+
3.
Do you identify as
Aboriginal
Torres Strait Islander
Both Aboriginal and Torres Strait Islander
None of these
4.
I was born
in Australia
overseas
5.
If you were born overseas, which country were you born in?
6.
Do you speak a language other than English at home?
Yes
No
7.
If you do not speak English at home, which language do you speak?
8.
In Western Downs do you live
in town
out of town
I don't live in the Western Downs all the time (eg FIFO/DIDO)
I don't live in the Western Downs (eg visitor)
9.
What is your postcode where you live most of the time?
10.
I am (tick all that apply)
employed full time
employed part time
employed as a casual
looking for work
looking for more work
unemployed
studying
parenting children under school age
parenting primary aged children
parenting teenagers
living with a disability
caring for a family member or friend
retired
receiving government payments eg pension, Jobseeker, DSP
self employed
volunteering
unable to work due to poor health
11.
What is your current housing situation? (tick all that apply)
I live in my own home
I rent
I have housing today, but I am worried about the affordability and security of my housing in the future
I do not have housing. I am staying with others, in a hotel, living outside on the street, in a car, in or near an empty building or in a park or camping ground
Camp or rig eg Base Camp, Stayover
My employer provides my home
Other (please specify)
12.
Do you
live alone
live with family
live with friends
board eg Stayover, Base Camp, private arrangement
Other (please specify)
13.
Thinking about the place you live. Do you experience any of the following? (tick all that apply)
poor physical housing conditions such as mould, lead paint, repairs not attended to
don't feel secure in my home
don't feel secure in my neighbourhood due to the threat of crime
overcrowding
I feel safe, but am aware of crime in my area
none of these
Other (please specify)
14.
How do you get around? (tick all that apply)
drive myself (own car/motorbike)
walk
ride a bike
mobility scooter
get a lift with family
get a lift with friends or neighbours
taxi
courtesy bus
NDIS or aged care service provider
Other (please specify)
15.
Do you have a pet?
dog
cat
Other (please specify)
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