About you

We don’t need to know your name or address but we would like a few personal details. Your information will only be used for statistical purposes and you will not be identifiable in any published results.

Home postcode
Gender
Male
Female
Are you of Aboriginal or Torres Strait
Islander descent?
Yes
No
Age group
12-17 years
18-24
25-34
35-44
45-54
55-64
65-74
75 and over
How long have you lived in Canberra
(add up periods of 6 months or more)
Up to 2 years
2-4
5-9
10-19
20-29
30-39
40-49
Over 50 years
Number and age of children (if any)
(write number of children in box)
Up to 2
years		 2-4
years		 5-11
years		 12-17
years		 18-34
years		 35-44
years		 45-54
years		 55 and
over
Employment category
Student
Looking for employment
Employed full-time
Employed part-time
Retired
Where were you born?
ACT
Elsewhere in Australia
Overseas English speaking country
Overseas non-English speaking country
Where were your parents born?

Both in ACT
One parent in ACT
Both elsewhere in Australia
One elsewhere in Australia, one overseas
Both overseas

What special interest organisations
do you belong to or volunteer for?