1. Please complete the following questions.

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* 1. Name:

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* 2. Address:

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* 3. Did you find the visit by Project 101 staff useful?

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* 4. Would you use Project 101 services in the future as a result of this visit?

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* 5. Was your visit at a suitable time?

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* 6. Do you feel you had enough time to discuss any issues with Project 101 staff?

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* 7. Do you feel that any issues you raised during your visit were adequately followed up afterwards?

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* 8. From the list of items contained within your starter pack please tick whether you found each item useful or not useful.

  Useful Not Useful
Washing Powder
Toilet Rolls
Washing-Up Liquid
Toothbrush
Toothpaste
Soap
Shampoo
Cream Cleaner
Bulbs
Dustpan & Brush
Washing- Up Basin
Rubber Gloves
Scouring Pads
Potato Peeler
Cleaning Cloths
Kitchen Utensils
Clothes Pegs
Dish Clothes
Dish Clothes
Hand Towel
Bath Towel
Colander
Plates
Mugs
Tin Opener
Cutlery
Measuring Jug
Dish Brush
Oven Glove
Alarm Clock
Cutlery Tray

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* 9. Are there any items which are not included in the starter pack which you feel should be?

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* 10. Are there any changes which you think could be made that would improve this service?

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* 11. Can Project 101 contact you in the future to ask your views on Youth Housing Issues?

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* 12. Any other comments

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