Fresh Air for Hout Bay

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Fresh Air for Hout Bay

Basic information

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These questions will help us gather some basic demographic information. This will help us understand the community better.

1.

Please provide us with your contact information. This will be kept private and only used by FAHB with your permission.

First Name
Last Name
E-mail Address
Telephone

2.	Do you live in Hout Bay? Yes No No, but I visit Hout Bay regularly

3.

If you live in Hout Bay, which area do you live in?

4.	What is your age? 18 or younger 19-35 35-55 55 or older

5.	Are you male or female? Male Female

6.	Which of the following categories best describes your employment status? Employed, working full-time Employed, working part-time Not employed, looking for work Not employed, not looking for work Retired Disabled and not able to work Student

7.

Which of the following best describe your current occupation? Select categories that are applicable.

Education or training
Community of social services
Business and industry
Tourism or hospitality
Health care
Fishing or agriculture
Legal occupations
Arts, design, entertainment
Media and communications
Security
Construction, maintenance, repair and other services
Office or administrative
Accounting, marketing and finance
Transport
Personal care
Domestic services
Other (please specify)

8.	How many people live in your household?

9.	Do you rent or own the place where you live? Own Rent Other (please specify)

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