* 1. Which age group best describes you:

* 2. What is your gender?

* 3. Which ward of Bessemer City do you reside?

* 4. How long have you lived in Bessemer City?

* 5. Please rate each of the following aspects of quality of life in Bessemer City:

  Excellent Good Fair Poor Don't know
Bessemer City as a place to live
Your neighborhood as a place to live
Bessemer City as a place to raise a child
Bessemer City as a place to work
Bessemer City as a place to retire
The overall quality of life in Bessemer City

* 6. Please rate each of the following characteristics as they relate to Bessemer City as a whole:

  Excellent Good Fair Poor Don't know
Overall feeling of safety in Bessemer City
Overall ease of getting to the places you usually have to visit
Quality of overall natural environment in Bessemer City
Overall "built environment" of Bessemer City (including overall design, buildings, and parks) 
Health and wellness opportunities in Bessemer City
Overall opportunities for education and enrichment
Overall economic health of Bessemer City
Sense of community
Overall image or reputation of Bessemer City

* 7. Please indicate how likely or unlikely you are to do each of the following:

  Very likely Some what likely Some what unlikely Very unlikely Neither likely nor unlikely
Recommend living in Bessemer City to someone who asks
Remain in Bessemer City for the next five years

* 8. In the last 12 months, about how many times, if at all, have you or other household members done each of the following in Bessemer City?

  2 times a week or more 2-4 times a month Once a month or less Not at all
Used County recreation centers or their services
Visited a neighborhood park or community park
Used Bessemer City public libraries or their services
Participated in religions or spiritual activities in Bessemer City
Carpooled with other adults or children instead of driving alone
Walked or biked instead of driving
Volunteered your time to some group/activity in Bessemer City
Talked to or visited with your immediate neighbors
Done a favor for a neighbor
Visited a cultural facility

* 9. Please rate the quality of each of the following services in Bessemer City:

  Excellent Good Fair Poor Prefer not to answer
Traffic enforcement
Street repair
Street cleaning
Street lighting
Sidewalk maintenance
Traffic signal timing
Garbage collection
Recycling
Yard waste pick-up
Storm drainage
Drinking water
Sewer services
Utility billing (water/sewer)
City parks
City recreation programs or classes
City recreation centers or facilities
Land use, planning and zoning
Code enforcement (weeds, abandoned buildings, etc.)
Animal control
Economic development
Health services
Public library services
Public information services
Emergency preparedness (services that prepare the community for natural disasters or other emergency situations)
Preservation of natural areas such as open space, farmlands and greenbelts
Bessemer City open space
Overall customer service by Bessemer City employees (police, receptionists, planners, etc.)

* 10. Please use the space below to provide additional comments, concerns, or ways for us to improve. 

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