Kensworth Consulting

SURVEY

Thank you for taking the time out to complete this survey. Please take a moment to tell us about your personal experiences in the City of Mount Vernon. All information obtained through this survey is solely for informational purposes and will only be used to create an effective Connecting Neighborhoods Summit on Saturday, June 23, 2007 from 9:30AM to 4:00PM at First United Methodist Church, 227 East Lincoln Avenue, Mt. Vernon.

First Name:

Last Name:

Organization Name:
(You do not have to belong to an organization to take the survey)

Street Address:

Address: (cont.)

City: Mount Vernon

State: NY

Zip Code:

Day Phone: (ex: 1234567890)

Evening Phone: (ex: 1234567890)

E-mail Address:
(Please include your e-mail address. This is the most cost effective and quickest form of communication)

Kensworth Consulting Network E-mail List: I would like to receive future information via my e-mail. I have neatly included my e-mail address above and ask you please ad me to the Kensworth Consulting Network e-mail list.

Yes No

PART 1- NEIGHBORHOOD ISSUES

1.	Overall, how satisfied are you with your Neighborhood Cleanliness?
	Very Satisfied
	Satisfied
	Neutral
	Dissatisfied
	Very Dissatisfied

1(a).	If you are dissatisfied, why?

2.	Would you say Crime is a problem in your neighborhood?
	Definitely
	Probably
	Probably not
	Definitely not
	Not sure

2(a).	If you have any additional comments in regard to Crime, please share them:

3.	Rate your satisfaction with the response of the following municipal departments to your neighborhood:
	Sanitation:
	Extremely Responsive
	Responsive
	Neutral
	Somewhat unresponsive

	Building Department:
	Extremely Responsive
	Responsive
	Neutral
	Somewhat unresponsive

	Police:
	Extremely Responsive
	Responsive
	Neutral
	Somewhat unresponsive

	Fire:
	Extremely Responsive
	Responsive
	Neutral
	Somewhat unresponsive

	Recreation / Youth Department:
	Extremely Responsive
	Responsive
	Neutral
	Somewhat unresponsive

3(a).	Please explain your above answer:

4.	How often do experience (If any) Traffic concerns (Speeding, Traffic Signs, etc.)
	One a year
	Several times a year
	About once a month
	About once a week
	Daily
	Other

	If Other, please specify:

4(a).	If you have experienced traffic concerns, please explain the specific nature of your concern:

5.	If you have any additional questions or comments please add them below:

PART 2 - ORGANIZATION ISSUES

1.	What is your level of satisfaction concerning these issues facing your organization:
	Membership:
	Important
	Neutral
	Not Important

	Fundraising:
	Important
	Neutral
	Not Important

	Publicity:
	Important
	Neutral
	Not Important

	Events:
	Important
	Neutral
	Not Important

	Technology (Web-site):
	Important
	Neutral
	Not Important

	Organizational (By Laws, etc.):
	Important
	Neutral
	Not Important

2.	How often does your organization hold official meetings?
	One a year
	Several times a year
	About once a month
	About once a week
	Other

	If Other, please specify:

3.	What organizational topics would you be interested in at the Connecting Neighborhoods summit?

4.	If you have any additional questions or comments please add them below:

A Community Initiative by Mount Vernon City Councilpersons Steven D. Horton and Loretta J. Hottinger

When: Saturday, June 23, 2007

Where: First United Methodist Church, 227 East Lincoln Avenue, Mt. Vernon, NY

Time: 9:30am - 4:00pm

Click Here to Download Survey