Appendix 1: Sample Survey Forms



A copy of the survey used by the research team is provided in this Appendix. Owing to the volume of responses, the completed surveys are being provided to Corinthian HDC as a separate deliverable.

West Side Park Survey

This survey is designed to provide local residents’ feedback to Corinthian Housing Development Corporation’s ongoing revitalization efforts in its 96 block target area within Newark’s Central Ward. Corinthian believes that with sufficient community input and involvement, West Side Park can function as an important focal point for neighborhood redevelopment. By determining frequency of park usage, reasons for not using the park, and possible improvements, Corinthian will be better suited to work with the City of Newark, Essex County, and other organizations to enhance the park and surrounding areas.

Corinthian would also like to get community feedback on criminal activity and safety. Your input on places of criminal activity and types of crime will be helpful in designing strategies to enhance community safety. All information is strictly confidential and we would be grateful for your participation.

  1. How often do you use West Side Park?

    2. More than once per week
    Once per week
    Several times per month
    Never
  2. What are your reasons (if any) for not using the park?

    3. Crime*
    Distance from home/work
    Lack of activities/programs
    Lack of equipment/amenities
    Other _____________________________

    * If you have specific crime concerns, please explain: (ex: types of crimes, crime locations, etc.)

  3. How do you access the park?

    4. Walk
    Bicycle
    Drive
    Bus
  4. Is there a particular street or block you prefer to avoid when traveling to the park? (Please provide specific location)


  5. What physical improvements would you like to see made to the park?


  6. What types of recreation programs and family-oriented activities would you like to see in the park? (ex: concerts, festivals, etc.)


  7. Would you be willing to contribute your time/energy to park restoration?

    8. Yes
    No
  8. Would you be willing to contribute your time/energy to recreation programs?

    9. Yes
    No
Community Safety
  1. What type of violent crime are you most concerned about?

    2. Rape
    Murder
    Robbery
    Domestic Violence<
    Drugs
    Assault
    Car Jacking
    Gang-Related
  2. What type of quality of life crime are you most concerned about?

    3. Prostitution
    Loitering
    Public Drunkenness
    Noise
    Vandalism
    Burglary
    Car Theft
  3. At what time of the day or evening are you most concerned about violent crime?


  4. Where do you feel the most crime ridden and dangerous area is in this neighborhood? (Be specific)


  5. Have you ever been the victim of a crime in this neighborhood?

    6. Yes
    No
    1. If you answered yes to question 5, what type of crime were you the victim of?
      (Check all that apply)
      Rape
      Robbery
      Burglary
      Gang-Related Car Theft
      Assault
      Domestic Violence
    2. Where did this crime occur?


  6. Are you involved in a neighborhood watch program?

    7. Yes
    No
  7. If not, would you like to be in such a program?

    8. Yes
    No
  8. Would such a program would make you feel safer?

    9. Yes
    No
  9. If you would be willing to contribute your time/energy to park restoration, recreation programs, or a neighborhood watch program please provide your name, address, and phone number and return this form to Corinthian. Indicate what your skills and/or interests are.

    10. Name: ______________________________
    Address: ______________________________
                  ______________________________
    Phone Number: ____________________________
    Skills/Interests: ___________________________________________________________


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