Feedback form | Have Your Say Willoughby

1.

How would you like to use the space? tick all that apply.

* required

Borrow library books and other resources

Attend a library program/activity

Use the study/work space

Drop-in to use the space for a community meeting or group activity

Community venue hire

Other (please specify)

2.

First name

* required

Maximum 255 characters

0/255

3.

Last name

* required

Maximum 255 characters

0/255

4.

Community group/organisation/business name (if appropriate)

Maximum 255 characters

0/255

5.

Position in community group/organisation/business (if appropriate)

Maximum 255 characters

0/255

6.

Email

* required

7.

Postcode

* required

Maximum 4 characters

0/4

8.

Gender

Female

Male

Non binary

Prefer not to say

Another gender identity (please specify)

9.

Age group

Select option

10.

Suburb

* required

Select option

11.

Your connection to Willoughby Local Government Area

* required

Resident

Ratepayer

Business owner

Worker

Study here

My child(ren) go to school here

Visitor

Other (please specify)

12.

Language/s used at home other than English.

Mandarin

Cantonese

Japanese

Korean

Hindi

Armenian

Filipino/Tagalog

Spanish

Italian

Thai

Other (please specify)

13.

Did we provide you with all the information you needed and make it easy to have your say?

* required

Completely

Mostly

Moderately

Not very well

Not at all