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1. Your Age:

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2. Your Gender:

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3. Your neighborhood / subdivision name:

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4. Name (optional):

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5. Street Address: (optional)

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6. Telephone number: (optional)

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7. Please check the box that best describes your most recent contact with the Lee's Summit Police Department in the last three (3) years:

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8. How many years have you lived in Lee's Summit?

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9. Overall, how would you rate the performance of the Lee's Summit Police Department?

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10. How would you rate the overall competency of the Police Department employees you had contact with?

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11. How would you rate the attitude of the Lee's Summit Police Officer(s) you have come in contact with?

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12. How would you rate the behavior of the Lee's Summit Police Officer(s) you have come in contact with?

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13. How would you rate your feeling of safety and security within the City of Lee's Summit?

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14. How safe do you feel walking within the City of Lee's Summit?

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15. Please list any concerns that you have regarding the safety and security of yourself, your family or workplace.

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16. Please list any additional recommendations or suggestions on ways that the Lee's Summit Missouri Police Department can better serve the citizens.

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