Neighbourhood Action Consultation 2014

Please return paper copies to: Neighbourhood Action, Resident Services, Civic Centre, Marlowes, Hemel Hempstead, Herts, HP1 1HH, or leave in the drop box in your community centre.

Q1Please tell us which area you live in from the list below. If you live outside these areas there is no neighbourhood action group working in your local area. Contact us at www.dacorum.gov.uk , customer.services@dacorum.gov.uk or 01442 228000 to tell us about any problems.

Adeyfield

Bennetts End

Bourne End/Felden/Box Lane

Gadebridge, Warners End and Chaulden

Woodhall Farm, Grovehill and Piccotts End

Hemel Town

Highfield

Your postcode Required so we can see if there are issues in any particular area

Q2Overall, how satisfied are you with your area as a place to live? (Please tick one only)

Q3Thinking about your area, how satisfied are you with each of the following?(Please tick one box for each line)

	Very satisfied	Fairly satisfied	Neither satisfied nor dissatisfied	Fairly dissatisfied	Very dissatisfied	Don’t know
Facilities and activities
Community centre
Community activities
Activities children
Activities teenagers
Activities older people
Parks and open spaces
Sports leisure
Keeping the following places clean from litter, fly tipping and graffiti:
Streets
Public land (such as grass verges and communal gardens)
Parks and open spaces
Environment
Refuse collection
Recycling centres
Parking
Road repairs
Living
Job prospects
Levels of crime

Q4If you have said you are dissatisfied with any of the topics in question 3 please tell us why.

Topic:

Q5Thinking about your area, are any of the following an issue for you? Please tick one box for each line.

	Not an issue at all	Not a big issue	A fairly big issue	A very big issue	No opinion
Noisy neighbours or loud parties
People hanging around the streets
People using or dealing in drugs
People being drunk or rowdy in public places
Vandalism, graffiti and other deliberate damage to property and vehicles
Abandoned or burnt out cars

Q6Is there anything else you would like to tell us about living in your area?

Please note this question is intended to help us understand the needs of residents in your neighbourhood. We will not be able to respond to you individually.

If you wish to let us know about a specific issue please contact the Neighbourhood Action Team on neighbourhood.action@dacorum.gov.uk or call 01442 228000 and ask for Neighbourhood Action.

Free prize draw

If you would like to be entered into the free prize draw to win £100, or to get involved with your local Neighbourhood Action Group please provide your contact details below.

All entries must be returned by 5pm on Monday 28 July 2014. The prize winner will be informed within two weeks of the draw.

Read the free prize draw terms and conditions.

The answers you have given so far are confidential and will not be linked to your contact details.

Q7Your information(Please tick all that apply)

Please enter me into the free prize draw, I accept the terms and conditions

I am interested in getting involved in neighbourhood action for my area

I would like to be kept up to date with what’s happening in my area by email

I am interested in finding out more about exercise opportunities in my area

If you have ticked any of the above, please give us your contact details. Your personal information will be processed in line with the Data Protection Act 1998.

Title: Required

First name: Required

Last name: Required

Enter postcode: Required

House number: Required

Street: Required

Town: Required

County: Required

Postcode: Required

Email address:

Telephone number:

Mobile phone:

Thank you for taking the time to complete this neighbourhood action consultation. Your views are important to us. The information will help us work with residents to improve your area.

If you have any questions about the consultation please contact neighbourhood.action@dacorum.gov.uk

If you would like this survey in another format, such as large print or another language please call 01442 228305.

Please complete the following equal opportunities monitoring form. The questions are completely optional but your answers will help us to ensure we are hearing from and considering all sections of the community.

The information will be used for the purpose of this survey only and will be processed in line with the Data Protection Act. All answers will remain confidential and no third party will be involved in processing the information.

Equal opportunities monitoring

Q2Are you male or female?

Male

Female

Q3Do you consider yourself to have a disability?

Yes

Prefer not to say

Disability is defined in the Disability Discrimination Act 1995 as "a physical or mental impairment, which has a substantial and long term adverse effect on a person's ability to carry out day to day activities". (Long term in this definition is taken to mean more than 12 months). This definition also includes long term illnesses such as cancer and HIV or mental health.

Q5What is your current employment status?

Employed

Unemployed

Self-employed

Full time carer

Retired

Student

Q6Please tell us your housing tenure

Owned outright

Mortgaged

Rented from housing association/trust

Rented from council

Rented from private landlord

Other