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Financial Inclusion Questionnaire

We are asking you to complete this questionnaire so we can find out how we can provide the
most appropriate money advice.
* 1. Where do you live?
Blaenau Gwent
Monmouthshire
Newport
Powys
Torfaen
Other (please specify)

* 2. Are you?
A Melin Resident
A Social Housing Tenant
Private Renting
A Homeowner
A Student
Living with parents
Nursing / Care Home resident
Homeless

Other (please specify)

* 3. How many people live in your household?

4. What are the ages of people living in your household?


Person 1
Person 2
Person 3
Person 4
Person 5
Person 6

* 5. What type of property do you live in?


House
Bedsit
Nursing/Care Home
Flat
Sheltered Scheme
Shelter
Bungalow
Other (please specify)

6. Number of bedrooms in the property?

7. What is your employment status?


Employed
Retired
Unemployed and seeking employment
Unemployed and not seeking employment
Self Employed
Full Time Student
Other (please specify)

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8. Are you worried about the cost of your energy bills?


Yes
No
Not Sure

9. Do you spend more that 10% of your income on utility bills?


Yes

No
Not Sure
10. Are you in receipt of benefits?
Yes
No
Not Sure

11. Are you worried about the changes to your benefits?


Yes
No
Not Sure
12. Would you like benefit advice?
Yes
No
Not Sure

13. Would you be interested in help with looking for employment?


Yes
No

14. Do you have a bank account?


Yes
No

Not Sure

15. If no, would you like help or advice to open a basic bank account?
Yes
No
Not Sure
16. Would you like advice on managing your money?
Yes
No
17. Do you think you make the most of your money?
Yes
No
Not Sure

18. Have you considered saving with your local Credit Union?
Yes
No

19. Would you like information on Credit Unions and Moneyline Cymru?
Yes
No

20. Would you like advice on how to manage any debts?

Yes
No
21. Have you ever considered using an illegal lender/loan shark?
Yes
No
22. Would you like to see financial education in schools?
Yes
No
Not Sure

23. Do you have access to a computer?


Yes
No

24. Do you have access to the internet?


Yes
No

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25. Would you be interested in receiving financial advice?


Yes
No
26. Can we contact you with information about the questions you have answered?
Yes
No
27. How would you prefer to be contacted?
Post
Email
Phone
Not at All
Complete this survey and you will be entered into a competition to win 50 in High Street
Vouchers.
Your details will remain confidential and will not be passed on to other agencies without your
prior permission.
28. Please enter your details below
Name:
Address 1:
Address 2:
City/Town:

County:
Postal Code:
Email Address:
Phone Number:
Thank you for taking the time to complete this questionnaire.