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Excellent questionnaire template which measures satisfaction with local government. You can conduct a survey based on this template, or a customer satisfaction survey template by joining SurveyShare. Just click on the SurveyShare banner, or the link that reads create internet survey. You could customize an excellent survey based on this example by clicking on the SurveyShare banner at the top of the screen. This sample questionnaire contains the following 17 questions which collect opinions about local government from participants:
  • 1) Do you feel the job the Mayor is doing is Excellent, Good, Fair, or Poor?
  • 2) Do you feel the job your city council person is doing is Excellent, Good, Fair, or Poor?
  • 3) Are you registered to vote?
  • 4) Did you vote in the last LOCAL election?
  • 5) Have you ever contacted your Mayor's office about a problem or concern you have had?
  • 6) Have you ever contacted your city council person about a problem or concern you have had?
  • 7) The Mayor is aware of what is happening in the community and acts promptly on issues of community well-being.
  • 8) The local city council members listen to residents in the community and respond appropriately.
  • 9) The well-being of the community as a whole is considered more important then the needs of a few when important decisions affecting the community are made.
  • 10) The Mayor cares more about being re-elected then solving important problems in the community.
  • 11) City Council members care more about being re-elected then solving important problems in the community.
  • 12) Do you attend City Council or planning meetings that are open to the public?
  • 13) What, if anything, do you feel can be done to improve the functioning of local government?
  • 14) What is your age?
  • 15) Are you male or female?
  • 16) What is your total household income?
  • 17) What is the highest level of education you have completed?
   
   
1) Do you feel the job the Mayor is doing is Excellent, Good, Fair, or Poor?
Excellent
Good
Fair
Poor
2) Do you feel the job your city council person is doing is Excellent, Good, Fair, or Poor?
Excellent
Good
Fair
Poor
3) Are you registered to vote?
Yes
No
4) Did you vote in the last LOCAL election?
Yes
No
5) Have you ever contacted your Mayor's office about a problem or concern you have had?
Yes
No
6) Have you ever contacted your city council person about a problem or concern you have had?
Yes
No

Please tell us how strongly you agree or disagree with the following:

7) The Mayor is aware of what is happening in the community and acts promptly on issues of community well-being.
Strongly Disagree
Disagree
Undecided
Agree
Strongly Agree
8) The local city council members listen to residents in the community and respond appropriately.
Strongly Disagree
Disagree
Undecided
Agree
Strongly Agree
9) The well-being of the community as a whole is considered more important then the needs of a few when important decisions affecting the community are made.
Strongly Disagree
Disagree
Undecided
Agree
Strongly Agree
10) The Mayor cares more about being re-elected then solving important problems in the community.
Strongly Disagree
Disagree
Undecided
Agree
Strongly Agree
11) City Council members care more about being re-elected then solving important problems in the community.
Strongly Disagree
Disagree
Undecided
Agree
Strongly Agree
12) Do you attend City Council or planning meetings that are open to the public?
Yes
No
13) What, if anything, do you feel can be done to improve the functioning of local government?
14) What is your age?
15) Are you male or female?
16) What is your total household income?
17) What is the highest level of education you have completed?

 
   

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