Parental Satisfaction Survey 2011 - 2012 Trafford Children's Centres are actively trying to work with local communities to share information of services on offer, and to seek your views on what you want from your Centre. About You (the parent filling out this form) Question Title * 1. Gender: Male Female Question Title * 2. Ethnic Group: White British White Irish White Traveller of Irish Heritage White Gypsy / Roma Any Other White Backgroud Asian or Asian British Indian Asian or Asian British Pakistani Asian or Asian British Bangladeshi Any Other Asian Background Black or Black British Caribbean Black or Black British African Any Other Black Background Mixed White and Black Caribbean Mixed White and Black African White and Asian Any Other Mixed Background Chinese Other Ethnic Group Prefer Not To Say Question Title * 3. Age: Under 16 16 - 21 21 - 30 31 - 40 41+ About Your Family Question Title * 4. Number of adults in the household: Question Title * 5. Number of Children under 5 yrs: Question Title * 6. Number of Children over 5 yrs: Question Title * 7. So we can identify which Children's Centre area you live in, please tell us your postcode: All responces to this survey will go into a prize draw to win Mothercare vouchers (£100, £50 and £20) So we can contact you please tell us your......... Question Title * 8. Name: Question Title * 9. Email: Question Title * 10. Phone Number: Question Title * 11. Mobile: Question Title * 12. Do you use services linked to your Children's Centre? Yes No Next