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2012
October
C
CJP Pre-test
CJP Pre-test
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Hello:
This survey will help us to understand who is using the services offered by the Collaborative Justice Project, why and what you hope to achieve through our processes.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, you do not need to answer any questions which make you uncomfortable and you are free to withdraw from the survey at any time. If you do withdraw, we will not use any of the information you have provided.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate, that is, all he data will be combined and it will not be possible to distinguish individual contributions to the data. 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 the researchers, Jane Dickson-Gilmore or Vanessa Ciampa at Carleton University at 613-520-2600, extension 3686. or by email at the email addresses specified below.
Thank you very much for your time and support.
I. Personal Information:
This section helps us to know who is served by the CJP.
Marital Status
Single
Married
Common-law
Separated
Divorced
Widowed
Annual Household Income
$20,000 and under
$21,000-$35,000
$36,000-$50,000
$51,000-$65,000
$66,000-$80,000
$81,000-$100,000
$101,000-$150,000
$151,000+
Unemployed
Student
Highest Level of Education Completed. Please choose one.
Primary school
Some high school
High school diploma
Some post-secondary
College diploma
Bachelors degree
Masters degree
PhD.
Other: (Please Specify) ____________________________
II. Motivation for Seeking the CJP's Services.
This section will help us to understand why people seek our services and what they hope to gain through our services.
How often do you conduct surveys?
Weekly
Monthly
Quarterly
Annually
I. Personal Information.
This section helps us to know who we are serving at the CJP
Date of birth: ___________________ (Month/Date/year)
Gender
Female
Male
Other
How often do you conduct surveys?
Weekly
Monthly
Quarterly
Annually
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