Measuring Well-Being
in Canada
a
Discussion Kit

Group Profile

This form is made to be passed around for all participants to fill in. In some cases check marks are all that is required. In others, like the city name, the first person can write the name of the city and if others are from the same area they need only make check marks beside the name. If you are fewer than eight or ten people, everyone should be able to check in on the one form. If you are expecting more people, be prepared with additional copies.

1.

What city are you from or near?

2.

What is your postal code?

3.

How many in your group are Female?

How many are Male?

4.

Age group? How many are in these age groups?

Teens:

20s:

30s:

40s:

50s:

60s:

+:

5. First language?

6. Ethnic background?

7. Level of education? (put a check for each person in each category.)

elementary:

high school:

college:

bachelors degree:

postgraduate:

8. What portions of your time is? (enter approximate %)

paid work:

unpaid work:

volunteer:

leisure:

9. Type of employment?

full time:

part time:

at home:

self-employed:

unemployed:

student:

retired:

Other:

10. Occupation?

11. Religious community?

12. What media do you gather information from?

Other information about yourselves that you feel is relevant?

(For example, the name of organizations of groups that you belong to.)

Other comments?

Questions and comments are welcome.

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Last Update: March 17, 2001
Filename: http://www.SustainWellBeing.net/7GI/kit-profile.shtml