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* 1. Did you move to Goulburn City, one of the villages, or a rural area?

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* 2. What was the date of your relocation?

  Month Year
Please select

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* 3. Which town/city did you move from?

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* 4. How many people relocated as part of your household?

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* 5. Please indicate ages:

  Number of people
0-4
5-11
12-17
18-24
25-34
35-49
50-59
60-69
70-84
85+

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* 6. How many in your household are working and where?

  Goulburn Villages From home Other
0
1
2
3
4
5
6
>6

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* 7. For those in your household who are working, which industry/s?

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* 8. Do you own or operate a business in the region? If yes, please supply:

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* 9. Do the people in your household have tertiary qualifications? If yes, please specify:

T