Children’s Centre Parental Satisfaction Survey 2017

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1. About you and your family
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2. What is your postcode?

3. How many children do you have in the following age groups?

	0	1	2	3	4	5
Unborn	Unborn 0	Unborn 1	Unborn 2	Unborn 3	Unborn 4	Unborn 5
0-2 years	0-2 years 0	0-2 years 1	0-2 years 2	0-2 years 3	0-2 years 4	0-2 years 5
3-4 years	3-4 years 0	3-4 years 1	3-4 years 2	3-4 years 3	3-4 years 4	3-4 years 5
5- 8 years	5- 8 years 0	5- 8 years 1	5- 8 years 2	5- 8 years 3	5- 8 years 4	5- 8 years 5
9 or over	9 or over 0	9 or over 1	9 or over 2	9 or over 3	9 or over 4	9 or over 5

4. What is your gender

Male
Female
Rather not say

5. What is the makeup of your family?

Single Parent Family
Two Parent Family
Other (please specify):

6. Does anyone in your family have a disability? Please tick all that apply.

7. Do you currently use a free/funded childcare place? e.g Nursery, Pre-school, Childminder

Yes
No

8. If no is this because you

Have chosen not to take up a place
Are unable to get a place at your preferred setting
Are unable to find a place
Are not eligible
Other (please specify):

About your work

9. Please select the most appropriate statements about you (and your Partner’s) employment from the options below.

	You	Your partner
Full time parent/carer	Full time parent/carer You	Full time parent/carer Your partner
Working full time	Working full time You	Working full time Your partner
Working part time	Working part time You	Working part time Your partner
In full time education	In full time education You	In full time education Your partner
In part time education	In part time education You	In part time education Your partner
Not currently seeking employment/education	Not currently seeking employment/education You	Not currently seeking employment/education Your partner
In receipt of benefits	In receipt of benefits You	In receipt of benefits Your partner
Seeking employment	Seeking employment You	Seeking employment Your partner
Maternity/Paternity leave	Maternity/Paternity leave You	Maternity/Paternity leave Your partner