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Public Opinion Poll Survey

PUBLIC SERVICE
SCORE CARD

A Pop Survey Voter Evaluation
of Government Program Performance.

Everyone is invited to participate in this Public Service Scorecard
You can also print this survey and mail your opinions to your mayor,
city councilors, community, provincial, state, national & world leaders.
For statistical purposes, don't do this survey more than once a month.



A.   GOVERNMENT PERFORMANCE EVALUATION

Public Services can be evaluated with a score from 1 to 10
(1 is poor performance. 5 is average. 10 is a perfect score.)


Rate Government Performance from 1-10
for each of these public service areas

 
1.  Community, Local Government 
2. Provincial, State Government 
3.  National, Federal Government 
 
4.  Social Development Programs 
5.  Schools, Colleges & Education 
6.  Health, Welfare & Pensions 
 
7.  Economic Management Policies  
8.  Housing, Transit, Transportation 
9.  Environment, Energy & Resources  
10.  Justice, Public Safety, World Peace  
 
 

Your Evaluation of Government is a Percentage Score = ____%
(10 services x 10 points adds up to a Performance Score of 100%)
You can see your Public Service Score by completing this survey.



B.   GOVERNMENT BUDGET PRIORITIES

Should the following Government Budgets be  A,  B,  C  or  D?
( A=Increase Budgets.  B=Maintain Budgets.  C=Cut Budgets.  D=Undecided. )

Indicate Your Vote on any line by checking one of A, B, C or D.

11.   Should National Government Budgets be    A    B    C    D

12.   Should International Agency Budgets be    A    B    C    D

13.   Should Provincial and State Budgets be    A    B    C    D

14.   Should Community Government Budgets be    A    B    C    D




D.  VOTER PROFILE

For complete statistical profiles
check all items relating to you

male   female

child (-10)   teens (10+)   twenties
thirties   forties   fifties   seniors

single    married   parent   divorced

student   employed   unemployed   retired

  income (approx)  -$12,000   $12-24,000 
  $25-50,000     $50-99,000   $100,000+
  $Millionaire  $Multimillionaire  $Billionaire





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Last Name  
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