1. Some Information About You
 

First name:
Surname:
Email address:	*
Country:
State:	Please Select! NSW NT QLD SA TAS VIC WA Other Other:
Postcode:
Occupation:
Current housing:	Please Select! Home owner Renting
Your age:	Please Select! Under 18 18-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 61-65 66-70 71-80 81-90 91-100 Over 100
Planning to move?:	Please Select! Yes No Considering Could be tempted
Number of current children (not including grown up children):	Please Select! None Expecting 1 2 3 4 5 6 Over 6
Age of eldest current child:	Please Select! I have no children 0 to 12 months 1-2 years 3-4 years 5-6 years 7-8 years 9-10 years 11-12 years 13-14 years Over 14 years My children are all grown up
How did you find out about us?	Please Select! Email Internet Newspaper Friends Word of mouth Other

How would you rate your understanding of what an ecovillage is? Please Select! Excellent Average Limited No idea
Why? 

Why are you filling in this questionnaire on ecovillages? Tick the ones that apply to you:

Would like to live in one	Would like to learn more	Like to have input
Interested for the future	Have had previous experience	Sounds interesting
Other -    Please give details:

Please tick the statements below which you agree with:
I believe strong community is vital for a high quality of life
I am interested in exploring alternative building methods
I plan to work from home as much as possible
I would like to/or have a home based business 
I am interested in the concept of Permaculture
I am interested in chemical free food
I believe that responsible waste management is important
I would like to explore using alternative energy sources
I would like something different from a normal suburban block
I would like to have a say in the area surrounding my own block
I would benefit from a connection with the natural environment 
I would like somewhere better to bring up my children 

2. Your Ecovillage Preferences

Now imagine/pretend/dream that you have decided to buy a block in an ecovillage. You have the opportunity to determine exactly what you would want. Select you preferences for the items below:

Preferred overall ecovillage size (includes common property area)	Please Select! Less than 50 acres 50 acres 100 acres 200 acres Over 300 acres I have no preference
Preferred own block size	Please Select! Less than 250 sqm 250 sqm 500 sqm 750 sqm 0.25 acre 0.5 acre 0.75 acre 1 acre More than 1 acre I have no preference
Price you would be prepared to pay for your own individual titled block	Please Select! $80,000 to $130,000 $130,001 to $180,000 $180,001 to $230,000 $230,001 to $280,000 $280,001 to $330,000 $330,001 to $380,000 Over $380,000
How would you fund the purchase of your block	Please Select! Own funds Mortgage Other loan Undecided
Maximum travel time from central Sydney	Please Select! Up to 1 hour Up to 1.5 hours Up to 2 hours Up to 2.5 hours Over 2.5 hours
Should dogs or cats be allowed	Please Select! No to both Cats only Dogs only Yes to both

Is there anything else you would see as essential for you to move into the ecovillage?

Select the type of services and facilities that you would like to see provided?

Electricity	Waste disposal	Visitor accommodation
Water	Community centre	Village green
Phone	Cafe	School / learning centre
Internet access	Community general store	Regular forums
Intranet	Commercial area	Leisure services
Internal phone system	Second hand goods area	Bus service
Business area	LETS system (people trading goods & services using an additional alternative currency)
	Community Supported Agriculture
Other - Please specify :

Now your chance to really have your say!              

What do you think of the ecovillage concept?

What would be the key factor for you to live in an ecovillage?

Do you have any information, contacts, or know of any available land that you believe 
would be  relevant to this concept?

Having completed this questionnaire, would you consider purchasing a block in our ecovillage? and Why?

3. Feedback

Any additional feedback, comments or thoughts?