Here at the Town Hall we want to provide a service that is of a high quality and meets all your needs. We can only do this with your help. We would like you to spare us a few minutes to complete this survey and tell us what you think about our Shop Mobility service. Through conducting surveys in our venues and on line we hope to learn more about what is important to all our current customers and potential customers.

Some Helpful Hints Before you Begin Please read each question carefully and tick a box to indicate your answer. In most cases you will only have to tick one box but please read the questions carefully as sometimes you will need to tick more than one box. Answer the next question unless asked otherwise. Once you have finished please take a minute to check you have answered all the questions that you should have answered and then click on submit.

Q1	How satisfied are you that the staff at Loughborough Shopmobility provide a friendly and courtious service? Please tick üone box only
	Very Satisfied		Satisfied		Dissatisfied		Very Dissatisfied

Q2	How satisfied are you that the equipment provided by Loughborough Shopmobility is well maintained and reliable. Please tick üone box only
	Very Satisfied		Satisfied		Dissatisfied		Very Dissatisfied

Q3	How satisfied are you that the advance booking procedures operated by Loughborough Shopmobility are efficient and reliable. Please tick üone box only
	Very Satisfied		Satisfied		Dissatisfied		Very Dissatisfied

Q4	How satisfied are you with Loughborough Shopmobility's approach to health and safety. Please tick üone box only
	Very Satisfied		Satisfied		Dissatisfied		Very Dissatisfied

Q5	How satisfied with the current opening hours? Please tick üone box only
	Very Satisfied		Satisfied		Dissatisfied		Very Dissatisfied

Q6	Overall, how satisfied were you with the level of service you received from our booking and venue staff? Please tick üone box only
	Very Satisfied		Satisfied		Dissatisfied		Very Dissatisfied

Any Other Comments

	If there is anything else you would like to say about the Town Hall and / or the questions above please write in the box below. If referring to a question please identify which question you are referring to.

Tell us about yourself...

Are you ..?
	Male		Female

Which of the following age groups do you belong to? Please tick üone box only
	17 and under		30 to 44 years		65 years and over
	18 to 24 years		45 to 59 years
	25 to 29 years		60 to 64 years

Do you or the person/group you are representing have any long standing illness(es), disability(ies) or infirmity(ies)? Please tick üone box only
	Yes		No

To which of these groups do you consider you belong to? Please tick üone box only
	White British		Black or Black British Caribbean
	White Irish		Black or Black British African
	Any other White Background                                     (ü and write in below)		Any other Black or Black British Background (ü and write in below)
	Mixed White & Black Caribbean		Asian Indian
	Mixed White & Black African		Asian Pakistani
	Mixed White & Asian		Asian Bangladeshi
	Any other Mixed Background                               (ü and write in below)		Any other Asian background                                      (ü and write in below)
	Chinese		Other (ü and write in below)

Thank you very much for taking part in this survey.