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Facilitator Survey
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1.
About you/your group
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1.
Question 1.
What is your unique reference number?
2.
Question 2.
Will your participants also complete the participants evaluation?
Yes
No
3.
Question 3.
Full name
4.
Question 4.
Organisation (optional)
5.
Question 5.
Job title (optional)
6.
Question 6.
Email address
7.
Question 7.
What region was your workshop facilitated?
South East Wales
Mid & West Wales
North & Mid Wales
Wales & Borders
Unsure
8.
Question 8.
What local authority was your workshop facilitated?
Blaenau Gwent
Bridgend
Caerphilly
Carmarthenshire
Ceredigion
Swansea
Cardiff
Conwy
Denbighshire
Flintshire
Gwynedd
Isle of Anglesey
Merthyr Tydfil
Monmouthshire
Neath Port Talbot
Newport
Pembrokeshire
Powys
Rhondda Cynon Taff
Torfaen
Vale of Glamorgan
Wrexham
Herefordshire
Shropshire
Gloucestershire
Worcestershire
West Midlands
Staffordshire
Cheshire
Greater Manchester
Warrington
9.
Question 9.
What type of organisation do you work for?
Community councils
Schools
Youth groups
Accessibility groups
Other (please specify):
This is required
Input box for - Other (please specify):
10.
Question 10.
What method of delivery was used for your workshop?
Virtual
Face to face
Other (please specify):
This is required
Input box for - Other (please specify):
11.
Question 11.
What type of location was your workshop facilitated? E.g. Village Halls (Optional)
12.
Question 12.
What is the age breakdown of your group? Apply number of participants to each relevant age range.
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90-94
95-99
100 & over
13.
Question 13.
What is the ethnicity breakdown of your group? Apply number of participants to each relevant ethnicity group (optional)
White
British
Irish
Other
Asian or Asian British
Indian
Pakistani
Bangladeshi
Any other Asian background
Mixed
White and Black Caribbean
White and black African
White and Asian
Any other mixed background
Black or Black British
Caribbean
African
Any other black background
Other Ethnic Group
Chinese
I do not wish to disclose the ethnic breakdown of the group
