Section 4: Program improvement
14. How can the program be improved/extended to better meet your needs?
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15. Are there any parts of the service that you are not happy with?
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Section 5: Demographics
Age: _________________ Gender:
Male
Female
What type household do you live in?
Single
__________
Couple
Single parent
Couple with children
Other (specify)
What is your main source of income?
Paid employment
New Start Allowance (NSA)
(DSP)
Parenting Payment – Single (PPs)
Parenting Payment – Partnered (PPp)
Other
If employed is this on a……..
Casual
Permanent
Fixed term contract
Othe