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* 1. Name (optional)

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* 2. Gender

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* 3. Age Group

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* 4. Do you identify as an Aboriginal or Torres Strait Islander?

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* 5. Strategic Priorities - please rank the importance of theses priorities to you / and your family

  Not Applicable Low Priority Medium Priority High Priority
Access to services and facilities for people with disabilities
Access to services, facilities and care for seniors
Activities and facilities for youth
Bush fire prevention and control
Conservation and environmental management
Development of town centre
Economic development and employment
Events, arts and cultural activities
Aboriginal reconciliation
Sport and recreation facilities
Tourism attractions
Tourism marketing
Safety and security

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* 6. What do you value most about our Shire? Please summarise what you value most about living and/or working in the Shire of Collie

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* 7. Community Priorities - please describe what you would most like the Shire of Collie to focus on over the next 10 years.

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* 8. Shire Facilities and Services - please indicate your satisfaction with the facilities and services you use

  Not Applicable Poor Below Average Ok Good Excellent
Air Strip
Animal Control
Building & Planning Approvals
Caravan Park
Community Buildings
Cemetery Management
Community Engagement & Consultation
Council Leadership
Emergency Services (BFB & SES etc)
Environmental Health Services
Footpaths
Historic Building
Library
Natural Resources
Parks, Gardens, Playgrounds
Pest Control
Roads - Rural
Roads - Town
Sporting Grounds & Oval
Street Trees
Street Lighting
Water access
Storm Water Drainage
Swimming Pool
Waste Facilities

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