Citizens Audit Questionnaire

Edited By..“The Old Laundry”FINAL 24/8/0036 Berrymede Road SAMPLE/RESPONDENT NO.Chiswick (11-15)London W4 5JD CITIZENS AUDIT – STAGE 1Tel: 020 8994-9192 FC:105898/00 PLEASE WRITE ALL DETAILS IN BLOCK CAPITALSNAME: Mr/Mrs/Ms/Miss __________________________________________________________________________________ADDRESS: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________(16 – 22)POSTCODE: TELEPHONE NO. _____________________________________(AT LEAST 4 DIGITS NEEDED FOR ANALYSIS) (INCLUDE DIALLING CODE)INTERVIEWERS DECLARATIONI DECLARE THIS QUESTIONNAIRE WAS COMPLETED AND CHECKED BY ME, WITHIN THE CODE OF CONDUCT OF THE MARKET RESEARCH SOCIETYAND THE JOB INSTRUCTIONS. THE INFORMANT WAS UNKNOWN TO ME AT THE TIME OF THIS INTERVIEW.INTERVIEWER SIGNATURE: _________________________________________ DATE: ________________________INTERVIEWER NAME (PLEASE PRINT) ____________________________________ INT. No. (23 – 28)TIME INTERVIEW BEGAN _____________AM/PM TIME INTERVIEW ENDED ______________AM/PMOFFICE USE ONLYRESPONDENTS.O.C / / (29 - 34)PARTNERS.O.C / / (35 – 40)INTERVIEWER NOTE - CONFIDENTIALITYWHEN ...