Survey For Men

We appreciate you taking the time to complete this anonymous and confidential survey. Your views will assist us in designing a Men's Development Program in Plumas County and determine if there is interest in a development/prevention program exclusively for men. At this time, we would like to hear from Men over the age of 18 years old.

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* 1. What is your age?

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* 2. What area do you live closest to?

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* 3. Do you have your own transportation?

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* 4. Have you ever attended a personal development program or group?

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* 5. If you answered yes to question 4, please list any training/development programs or groups you have participated in.

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* 6. Would you be interested in attending a development group for men only?

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* 7. What topics would interest you, if you were to attend a development group just for men?

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* 8. If you attended a development program for men, how often would you like to meet?

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* 9. What are the best days of the week for you to attend a development group for men? Choose all that apply.

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* 10. What are the best times for you to attend a men's development group?

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* 11. As part of a development group, would you be interested in doing recreational/outdoor activities?

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* 12. As part of a development group for men, is there any skill that you would enjoy using or teaching others? For example; cooking, musical instrument, art, mechanics, fishing, etc.

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* 13. If you attended a development program for men, what are the main things you would want from it?

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* 14. Are there any other ideas you have that would help us to create a great development program that you would like to attend?

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* 15. Have you ever witnessed domestic abuse or family violence? (including emotional, mental, financial, sexual or physically abusive behavior)

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* 16. Have you ever been the victim of domestic abuse or family violence? (including emotional, mental, financial, sexual or physically abusive behavior?)

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* 17. Have you ever been accused of abusive behavior toward an intimate partner or family member?

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* 18. Have you ever thought that you could use help controlling your feelings of anger, frustration or rage?

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* 19. Do you have a good support network, people you can confide in when you need help?

Thank you for completing this survey. If you are completing a paper copy, please send it to Dana Nowling, Plumas Rural Services, 711 E. Main St, Quincy, CA 95971. If you require someone to collect the survey/s, please email dnowling@plumasruralservices.org and we will arrange collection.

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