Community relations

What area do you live in ?

Killowen area

Drumard Drive area

Kylemore Road area

Upper Heights area ie; buskin way etc

Other.....

How many dependants in your house ?

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Are you aware of your local community groups ?

Somerset Residents Associations

Killowen residents group

Other

if other please state:________________________________________________________________

Do you often attend the local events put on by the groups in the area?

YES

NO

If you answered no what reasons would be stopping you doing so ?

PRICE

VENUE/LOCATIONS

THE ACTIVITY

OTHER

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WHAT ACTIVITIES WOULD YOU LIKE SOMERSET RESIDENTS ASSOCIATION TO PROVIDE IN YOUR AREA ?

If a community hall or venue was ever created in the area would you make use of it and support it ?

YES

NO

If YES what would you use the venue for ?

If you would like to know more of what is going on in the area ie; events , activities etc please provide your information

First Name :

Last Name :

Address 1 :

Address 2 :

City :

State :

Zip :

Phone :

Email Address :

Country :

If you do want further information what language do you need it translated too ?

ENGLISH

POLISH

OTHER

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