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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. Area you identify with

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* 5. Do you live with a disability?

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* 6. What do you value most about our Shire? Please summarize what you value most about living and/or working in the Shire of Kent and your local community

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* 7. Shire facilities - please indicate your satisfaction with the Shire facilities you use

  Do not use Poor Good Excellent
Community Pavilion, Buildings and Halls
Public toilets
Sporting Playfields, Courts and Ovals
Libraries
Playgrounds
Parks and gardens
Caravan Parks
Refuse Sites
Cemeteries
Emergency services (fire sheds etc)
Camping and rest areas
Standpipes

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* 8. Facility Priorities - Based on your current situation please describe Shire facility priorities

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* 9. Shire Services - Please indicate your satisfaction with the services you use

  Do not use Poor Good Excellent
Building and Planning Approvals
Residential land development
Cat and Dog Control
Council leadership within the Community
Enforcement of local law
Environmental Health Services
Natural Resource Management
Footpath Construction
Footpath Maintenance
How the community is consulted and informed about local issues
Management of cemeteries
Ranger services
Road construction
Road Maintenance
Streetscaping and lighting
Water supply
Storm Water Drainage

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* 10. Strategic Priorities - Please rank the importance of these priorities to you / and your family over the next 10 years

  Not a Priority Low Priority Medium Priority High Priority
Provision and maintenance of community buildings, halls and public toilets
Access to services and facilities for Indigenous and culturally diverse groups
Access to services and facilities for people with disabilities
Bush fire prevention and control
Natural disaster management and adverse events planning
Conservation and environmental management including biodiversity, climate change, weed control, water conservation
Streetscape, amenity improvement, lighting and development of Town Centers
Economic and tourism development
Facilities, services and care available for Seniors
Delivery and support for events, arts and cultural activities
Sport and Recreation activities and facilities
Support for community groups, volunteers and clubs
Heritage and conservation of history
Safety, security and ranger services
Services and facilities for youth
Provision of parks, play spaces and public open spaces
Provison and maintenance of roads, grading and sealing
Services and facilities for families and early learning years
Waste collection, minimization, management and sustainability
Access, support and developments of housing options locally
Provision of footpaths and trails for access and recreation
Consultation, engagement and communication

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* 11. Additional comments / questions

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