Hindmarsh, West Wimmera, Yarriambiack and Horsham Rural City municipalities all work together in their emergency management and planning. We'd like your point of view, to ensure we're working on the things that worry you. Your knowledge and experience are important - we greatly appreciate you taking the time to share them with us.

* 1. Please select the top five emergency events that you believe are most likely to affect you and your community:

* 2. Where do you obtain emergency management information? Please select all that apply:

* 3. Have you or your community been affected by an emergency event? Please describe the event briefly:

* 4. How prepared are you for an emergency event in your municipality?

  Yes No Don't know
Do you have an emergency plan for yourself and/or your family?
Do you have an emergency kit to support you and/or your family for three days?
Do you know where to obtain emergency information from?
Do you know where you may evacuate to if required?
Do you have a communication plan to notify family and friends of your situation?
Do you have appropriate and adequate insurance?
Have you completed any emergency type training? e.g. First Aid
Do you know how to access the public versions  of your municipality's emergency management plans?
Is your house number clearly visible from the street?
Have you made copies of important documents to keep in your kit that you may need in an emergency?
Do you have smoke alarms in your house?
Do you regularly check your smoke alarms to ensure they are in working order?
Do you prepare your place of residence for an emergency e.g. fire, flood?
Does your place of work prepare for emergency events?

* 5. What could your Council or emergency management agencies (e.g. CFA, VICSES) do to help you feel safer or more able to cope with an emergency event?

* 6. In which municipality do you live?

* 7. Please select your appropriate age bracket:

* 8. Thank you for your help with this. We may be doing more work on this in the future. Would you be interested in talking to us then? If so, please provide your name and contact details:

T