Marklet
survey
Social Cohesion, Security and Governance Survey
Locality Feedback Form
Please select the most appropriate option based on your opinion.
Website
Full Name of Respondent
Contact Number (Optional)
Respondent’s Gender
Male
Female
Other
Prefer not to say
Age Group
Below 18
18–30
31–45
46–60
Above 60
How long have you been living in this locality?
Less than 1 year
1–5 years
6–10 years
More than 10 years
People in my locality trust and support each other.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
How frequently do you interact with your neighbors?
Never
Rarely
Sometimes
Often
Very Often
How safe do you feel in your locality, especially during night hours?
Very Unsafe
Unsafe
Neutral
Safe
Very Safe
How satisfied are you with safety and security facilities in your area (street lighting, police patrolling, emergency response)?
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
How satisfied are you with the performance of local authorities in providing basic services (water supply, roads, waste management)?
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
Submit Response
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