Shire of Chapman Valley - Welcome to the Shire of Chapman Valley

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Complete a Survey

The information you provide by completing this survey will be used to:

Enhance the effectiveness of the Shire of Chapman Valley Local Answers Project.
Help us to coordinate local skills recognition and assist residents in accessing employment and learning opportunities, and also
Support the development of a database which will document and promote local skills.

Without collecting some identifying information about you we would be unable to learn about, promote and better utilise local skills and knowledge. Your information will be maintained securely and will be accessible only to authorised Local Answers Project staff, you and persons contracted to the Shire in relation to the Shire of Chapman Valley Skills Survey project. We will not use or disclose the information for any other purpose without first obtaining your consent, or where there is a legal requirement for us to do so. Where information is required for statistical and/or reporting purposes, all identifying details will be removed. You will be able to gain access to the information we hold about you and seek to correct or remove it if necessary. Please contact the Local Answers Project Team in the first instance if you would like access.

The Shire of Chapman Valley Local Answers Project is committed to protecting your privacy. If you have any queries about how your information is handled and stored, please contact the Shire of Chapman Valley Local Answers Project on 08 9920 5011.

Acknowledgement: This survey has been based on a previous surveys developed by the University of Ballarat through its Centre for Electronic Commerce and Communications (www.cecc.com.au). The Local Answers Project Team sought and received permission to modify the survey for use in Shire of Chapman Valley in an effort to identify new opportunities for residents.

Please complete one (1) survey per person providing as much details as possible. Please answer all questions to the best of your ability.
Personal Details
Title
First name
Last name
Gender	Male Female
Address
Town
Postcode
Telephone
Mobile
Email
Age group
How long have you lived in Shire of Chapman Valley?
Locality:

Are you willing to share your skills

Formal Qualifications?

Please tick any applicable options below to indicate qualifications you have achieved.
High School	Apprenticeship
Traineeship	TAFE
College	University
Other (please specify)

Please provide details of any formal qualifications you have attained. Course name, year level etc

Do you have any recognised licences, or training?

Hobbies/other interests

Please provide details of any other interests or hobbies you have

Computer Access

Do you have access to a computer?

Yes No

If Yes, where?

Home School Library Work Other

Do you have access to the Internet?

Yes No

If Yes, where?

Home School Library Work Other

Employment Details

This section is about your current and past employment. We are interested in identifying both employment skills you have, and employment opportunities that you are seeking. Please complete all sections that currently apply to you.

Part A - For Everyone

How would you describe your working situation at the moment? Please tick all situations that apply to you, then complete the parts of the survey indicated for each situation.
Home Duties (Complete Part B)	Student (Complete Part C)
Employed (Complete Part D)	In Unpaid Work (Complete Part D)
Unemployed (Complete Part E)	Retired (Complete Part E)
Unable to work	Other (please specify)

Are you currently looking for work?
(Complete even if you are currently employed)

Yes	No (Please go to next relevant part)

What type of work are you looking for?
(e.g. construction, child care, administration)

What hours of work are you looking for?

Full-time

Part-time

Casual

Do you have a drivers licence?

Yes No If Yes, specify type(s)

Do you have a resume?

Yes No

If Yes, is your resume up to date?

Yes No

Would you like assistance with developing any of these job skills?
Resume building	Writing job applications
Interview skills	Searching for job vacancies
Personal presentation

Would like to develop your self-confidence and leadership skills?

Yes No

Would you like to learn more about the 'Rural Skills Passport' which aims to encourage the exchange of labour between the agriculture and mining sectors?

Yes No

Would you like to learn more about recognition of skill sets, or have your current skills accredited via recognition of prior learning?

Yes No

What is the main reason why you would like to develop your skills or have your current skills accredited via recognition for prior learning (RPL)?
Do what I do better	Diversify or supplement income
Move into a new field	Other (please specify)

Would you be interested in attending a farm diversification workshop?

Yes No

Would you be interested in attending small business development workshops?

Yes No

Would you be interested in participating in a study tour to learn about sustainable farming practices?

Yes No

What workshop would you like to see developed to assist your needs?

Part B - For those who have home duties
Main tasks and activities

Part C - For Students
Name of course you are studying
Type of study

Part D - For those who are in paid or unpaid work

Name of employer / organisation

Type of employment

Permanent full-time	Permanent part-time
Casual full-time	Casual part-time	Other (please specify)

Job title

Main tasks & activities

Part E - For those who are unemployed or retired

Previous job title

Main tasks and activities

Is there anything stopping you looking for paid work or undertaking training that would assist you in gaining employment?

Yes No

If yes, please tick all the boxes that apply to you.

Lack of childcare	Lack of confidence
Lack of full time jobs	Lack of part time jobs
Lack of information about jobs	Lack of local employment resume service
Lack of transport	Language barrier
Loss of concession cards	Increase in rent
Transport costs	Course fees
Effect on Centrelink payments	Apprenticeships - Low pay
Reading and writing skills	Hours of work
Health issues - physical	Health issues - mental
Personal issues
Other (please provide details)

Other:

If I could do something for my community, it would be ...
Category	Commitments
Improvements needed in our local parks, recreation reserves etc	None Yes I would like to see...
Improvements to Social Service. Health, child or aged care, education, community development	None Yes I would like to see...
Connections with my own community members - I am willing to	Meet with and get to know others in my street or community Help with community clean-ups Look out for/care for others in my community Help with Neighbourhood Watch Become a leader Be happily "led" by others
Connections with other communities - I am willing to	Share my knowledge with others doing community development work Establish and maintain working partnerships for the benefit of the whole region
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