EMCBP Feedback form

EAST MANCHESTER COMMUNITY BOAT PROJECT - FEEDBACK FORM

Thank you for booking "Community Spirit 2", we hope you have enjoyed your trip.

We want to ensure that we provide appropriate information and a professional service. It will help us if you could please take a few moments to answer the following questions:

Name of visiting group*

Date*

Date

TRIP START TIME

Hour Minutes

TRIP FINISH TIME

Hour Minutes

Satisfaction with the trip 1-5 Stars (1=not good - 5=very good)*

Satisfaction with the boat 1-5 Stars (1=not good - 5=very good)*

Satisfaction with the crew 1-5 Stars (1=not good - 5=very good)*

Total number of passengers*

Numbers of carers

Total Male

Total Female

AGE 0-10

AGE 11-30

AGE 31-50

AGE 51-70

AGE 70+

ETHNICITY (Please indicate the number in each group)

White British/Irish

Asian/Asian British

Black/Black British

Mixed

Other

DISABILITY (Please indicate the number in each group)

Hearing impaired

Vision impaired

Wheelchair user

Mental health

Other

If any of your group live in homes owned by The Jigsaw Group state how many?

IS THERE ANYTHING MORE THAT WE COULD DO TO IMPROVE YOUR EXPERIENCE TODAY?

IS THERE ANYTHING THAT WE COULD CHANGE TO PROVIDE A MORE SUITABLE ENVIRONMENT FOR YOUR NEEDS?

DO YOU KNOW OF ANY OTHER GROUPS THAT WOULD BENEFIT FROM OUR SERVICE? WOULD YOU PLEASE TAKE A LEAFLET TO PASS ON TO THEM or COULD YOU PLEASE LEAVE US THEIR CONTACT DETAILS

Additional comments from crew members if appropriate