Kingston MFRC Community Needs Assessment Survey

In this first section we are asking for information that can help us understand the composition of our community.

1. Your age:

Your age: 18 - 29

30 - 39

40 - 49

50 and over

2. Are you:

Are you: Male

Female

3. Where do you live?

Where do you live? On base at CFB Kingston

East Kingston (off base)

West Kingston

Central Kingston

Outside of Kingston

Other (please specify)

4. How far away from this MFRC is your residence located?

How far away from this MFRC is your residence located? Under 20 KM

20 - 50 KM

Over 50 KM

5. How long has your family been at this posting?

How long has your family been at this posting? Under 1 year

1 - 2 years

Over 2 years

6. How are you connected to the Military?

How are you connected to the Military? Single military member

One regular force member in family

Reserve force member in family

Dual service couple

Retired member

Parent of regular force or reserve member

Separated/divorced & parenting children with military member

Other (please specify)

7. Please provide information about all other family members living in your household.
(Gender & Age)

	Female	Male	0 - 5	6 - 11	12 - 17	18 - 25	26 - 30	31 - 40	41 - 50	51+
Person 1	Please provide information about all other family members living in your household. (Gender & Age) Person 1 Female	Person 1 Male	Person 1 0 - 5	Person 1 6 - 11	Person 1 12 - 17	Person 1 18 - 25	Person 1 26 - 30	Person 1 31 - 40	Person 1 41 - 50	Person 1 51+
Person 2	Person 2 Female	Person 2 Male	Person 2 0 - 5	Person 2 6 - 11	Person 2 12 - 17	Person 2 18 - 25	Person 2 26 - 30	Person 2 31 - 40	Person 2 41 - 50	Person 2 51+
Person 3	Person 3 Female	Person 3 Male	Person 3 0 - 5	Person 3 6 - 11	Person 3 12 - 17	Person 3 18 - 25	Person 3 26 - 30	Person 3 31 - 40	Person 3 41 - 50	Person 3 51+
Person 4	Person 4 Female	Person 4 Male	Person 4 0 - 5	Person 4 6 - 11	Person 4 12 - 17	Person 4 18 - 25	Person 4 26 - 30	Person 4 31 - 40	Person 4 41 - 50	Person 4 51+
Person 5	Person 5 Female	Person 5 Male	Person 5 0 - 5	Person 5 6 - 11	Person 5 12 - 17	Person 5 18 - 25	Person 5 26 - 30	Person 5 31 - 40	Person 5 41 - 50	Person 5 51+

7b. Please indicate the number of dependents living in your household in each of the following age groups:

8. Was a military member of your family deployed in the last two years?

Was a military member of your family deployed in the last two years? No

Yes

9. Does a military member of your family expect to be deployed in the next year?

Does a military member of your family expect to be deployed in the next year? No

Yes

10. Do you use the KMFRC?

Do you use the KMFRC? No

Yes

Explain response

11. Have you used MFRC’s at other bases?

Have you used MFRC’s at other bases? No

Yes

12. Rate the quality of your experiences at the KMFRC.

Rate the quality of your experiences at the KMFRC. Needs Improvement

Poor

Average

Good

Very Good

Excellent

Explain