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The City of Canada Bay Council Youth Services Team is working hard

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					The City of Canada Bay Council Youth Services Team is working hard to meet the needs of young people
between the ages of 12-24 who live, work, and study in the City of Canada Bay. To help us find out the views
and needs of young people the Youth Services Team at Council has developed this survey. Your views are
important to us and we appreciate your input and valuable feedback.

You do not have to disclose your name or any other information you do not wish to provide.


1. Personal Details

Full name (optional): ______________________________________________________________________

Suburb you live in: ___________________________________ Date of Birth: _________________________

Name of School (if applicable): ______________________________________________________________

Year (e.g. year 11): ______________________


2. Current employment status (if not attending school): please tick

    [   ] Employed part-time/casual    [   ] Employed full-time   [   ] Unemployed


3. Do you attend TAFE, University or other tertiary college?              [   ] Yes          [   ] No (go to Q4)
    If yes, please provide name of institute:
    ___________________________________________________________________________


    Please provide the name of the course you are undertaking or are enrolled in:
    ___________________________________________________________________________


4. Do you speak a language other than English?            [   ] Yes               [   ] No

    If yes, please specify: __________________________________


5. Do you currently live at home?

    [   ] Yes. Please list people currently living in your home (eg mum, dad, sister etc): _________________
    ___________________________________________________________________________________
    [   ] No. Please specify your living arrangement: ____________________________________________

6. How many siblings do you have? _________________________________________________


7. What is your parents’ employment status? (e.g. both parents work, dad only works, etc)
    ______________________________________________________________________________



City of Canada Bay Youth Survey 2006                                                                               1
9. Are you aware of the different types of youth services provided in the City of Canada Bay?
    [   ] No                 [   ] Yes, please specify: _______________________________________________


10. Please tick which of these issues you are currently or have recently experienced? You may tick
    more than one.

    [   ] Depression                   [   ] Low-self esteem                 [   ] Suicidal thoughts
    [   ] Poor body image              [   ] Stress                          [   ] Problems with police
    [   ] Bullying                     [   ] Financial hardship              [   ] Homelessness
    [   ] Peer pressure                [   ] Learning difficulties           [   ] Problems at school/with teachers
    [   ] Racism                       [   ] Discrimination                  [   ] Family relationship problems
    [   ] Sexual identity              [   ] Sexual harassment               [   ] Employment difficulties/unemployment
    [   ] Sexual abuse                 [   ] Physical abuse                  [   ] Emotional abuse
    [   ] Health                       [   ] Sexual health                   [   ] Boredom
    [   ] Other; (please specify) ________________________________________________


11. Would you be interested in attending workshops or services that address any of the above issues?
    [   ] Yes                          [   ] No


12. What are some after school or holiday programs you would be interested in attending?
    (You may tick more than one)
    [   ] Hip-hop music                [   ] Sound mixing (DJ) workshops              [   ] Public speaking
    [   ] Hip hop dance                [   ] Cartoon drawing                          [   ] Mentoring programs
    [   ] Graffiti project             [   ] Drama/theatre workshops                  [   ] Jewellery making
    [   ] Film-making                  [   ] Creative writing                         [   ] Pool, air hockey, PlayStation etc
    [   ] Movies                       [   ] Games night                              [   ] Bowling
    [   ] Sports; please specify: ______________________________________________________________
    [   ] Other (please list other activities that you would be interested in:
    ____________________________________________________________________________________


13. How much would you be willing to pay to attend any of the above activities or workshops?

    [   ] $5-$10             [   ] $20-$30                   [   ] $40-$50            [   ] more than $50


14. Are you aware that the City of Canada Bay Council has a Youth Centre at 1A Gipps Street, Concord?

    [   ] Yes
    [   ] No. What would attract you to the Youth Centre? _________________________________________
               _____________________________________________________________________________

15. Do you know that a new Skate Park is being built in Five Dock Park?

    [   ] Yes                                     [   ] No
    What kind of activities would you like to see at the new Skate Park?
    ____________________________________________________________________________________
    ____________________________________________________________________________________

City of Canada Bay Youth Survey 2006                                                                                        2
16. How much free or recreational time do you spend in the City of Canada Bay area?
    (Please tick appropriate box or boxes)

                                               1-2 hrs         2-4 hrs          4-6 hrs         More than 6 hrs
        After School/Work

        Weekends

        During School Holidays

        Other ______________________



17. Are you interested in receiving more information about Youth Services Programs? Eg school
    holiday programs, after school programs, workshops, Youth Reference Group etc.

    [    ] No                                      [   ] Yes, please provide contact details:

    Name: ________________________________ Contact number: ______________________________

    Address: ________________________________________________ Postcode: __________________

    Email: _____________________________________________________________________________

    (Complete this section if you would like to go in the draw to win a $50 Westfield voucher)

18. Would you be interested in joining the City of Canada Bay Council’s Youth Reference Group?
    The Youth Reference Group will be responsible for identifying issues relevant to young people in the City
    of Canada Bay and work to influence and inform Council decision making in regards to youth issues.

    [    ] Yes                                     [   ] No

19. How do you normally access information regarding youth activities?

    [    ] Internet                       [   ] Newspapers                  [   ] School newsletters
    [    ] Community Notice Boards        [   ] Library                     [   ] School assemblies
    [    ] Parents                        [   ] Friends                     [   ] School notice boards
    [    ] Other, please specify: ____________________________________

20. Please provide further comments on what you think would improve youth services in the City of
    Canada Bay:
    ____________________________________________________________________________________
    ____________________________________________________________________________________
    ____________________________________________________________________________________

                                                                         Date completed: _______/_______/2006


    Thank you for taking the time to fill in this survey. We will use this information to provide better outcomes
    for young people in our City. We assure you that any personal information you have disclosed in this
    survey will be kept confidential and treated with upmost respect. For more information on our privacy
    policy please visit our website at www.canadabay.nsw.gov.au, or direct enquiries to 9911 6555.

         Please return completed survey to Patty Veliz at 9911 6550 (fax) or City of Canada Bay
                 Council, Reply Paid 72345, Drummoyne NSW 1470 (no stamp needed).


City of Canada Bay Youth Survey 2006                                                                                3

				
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Description: The City of Canada Bay Council Youth Services Team is working hard