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  2. 2014
  3. April
  4. A
  5. A Safe Haven For Children
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Hello:
You are invited to participate in my survey A safe haven for children. In this survey, approximately 20 people will be asked to complete a survey that asks questions about Domestic Violence/ Programs. It will take approximately 10 minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for me to learn your opinions.


Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Krista Howington at 4916810

Thank you very much for your time and support.
 
 
 
Are you male or female?
 
male
 
female
 
 
 
Which category best describes your age group?
 
18-20
 
21-29
 
30-39
 
40-49
 
50-59
 
60 & older
 
 
 
What is your education status?
 
Less than High School
 
High school or Equivalent
 
Some College but no degree
 
Associates degree
 
Bachelors degree
 
Graduate degree
 
 
 
What is your race/ethnic background?
 
Black
 
American Indian or Alaskan Native
 
Asian
 
Native Hawaiian or other Pacific Islander
 
Multiple Races
 
 
 
Which of the following categories best describes your employment status?
 
Employed, working 1-39 hours per week
 
Employed, working 40 or more hours per week
 
Not employed, looking for work
 
Not employed, not looking for work
 
Retired
 
 
 
What is your relationship status?
 
single
 
in a relationship
 
married
 
widow
 
divorced
 
separated
 
 
 
How concerned are you about domestic violence ?
 
extremely concerned
 
very concerned
 
moderately concerned
 
slightly
 
not at all
 
 
 
Do you agree children are forgotten victims of domestic violence?
 
Agree
 
Disagree
 
Neutral
 
 
 
How many programs do you know of that provides counseling and other services like shelter, and education for children who are victims and or witnesses of domestic violence
   
Please list them