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Tell us about your concerns- and what you would like us to provide
How to fill in this form - it'll only take 5 minutes
There are two ways to tell us about your main environmental concerns and interests, and about yourself.
1. You can get a printout of this form - fill in the blanks and send it to us in the post to: IPCC Web Survey, Bog of Allen Nature Centre, Lullymore, Rathangan, Co Kildare, Ireland.
2. Alternatively you can send us an electronic version of
the form by e-mail. To send an e-mail click here to obtain
an e-mail form. Then select "Quote Document"
when you are presented with the e-mail form. This will download
this form into the e-mail form. You can then type in your responses
to our questions and send it to us electronically.
Your journey through our Web Site - Survey form
How did you come to contact IPCC's WWW site?
I read about it (e.g magazine, newsletter, advert etc.) (Y/N):
Details:
I found you on a Search engine (Y/N):
Details of the engine (e.g. Yahoo/Alta Vista etc.):
Which IPCC pages did you visit?
Home page (Y/N):
Index of resources (Y/N):
Clochar na gCon appeal (Y/N):
Information leaflets (Y/N):
Facts & figures on bogs (Y/N):
Upcoming events (Y/N):
Current IPCC campaigns (Y/N):
Education resources & services (Y/N):
Teacher training courses (Y/N):
Press releases (Y/N):
Recent IPCC publications (Y/N):
Volunteering (Y/N):
Membership (Y/N):
How to donate (Y/N):
Have you any comments about the pages/their information content/layout/usefulness?
Your comments:
Is there anything you feel we should include in future up-dates of the IPCC's Web site?
Details:
Did you respond (other than via this form) to any of our Web site appeals/requests for information or literature/ or how to join as a volunteer or member? (Y/N):
Details why you did or didn't:
Are you a member of any other environmental or campaigning group?
Name of group/its activities:
Have you ever worked as a volunteer for any campaigning group?
Name of group:
What did you do/for how long:
Have you ever donated to a fundraising appeal run by a campaigning group?
Name of group/the type of appeal:
How did you donate to the fundraising appeal - via post/collection box/raffle ticket/over the Net? Details/any problems you experienced:
Have you ever helped with a fundraising appeal run by a campaigning group? (e.g. sold raffle tickets, sponsored fast,walk, cycle etc.)
Details:
There are many ways you could help IPCC's Save the Bogs Campaign. Which of the following would you be prepared to help us with?
Raffles (Y/N):
Conservation Workcamps (Y/N):
Letter writing (Y/N):
Stamp sorting at home (Y/N):
Office work (Y/N):
Local fundraising (Y/N):
School visits (Y/N):
Distributing leaflets (Y/N):
Talks(Y/N) :
Meeting the public at shows and special events (Y/N):
Any skills you have that could help us:
Would you like us to send you occasional information about our campaigns by:
snail mail? (Y/N):
email? (Y/N):
If you answer yes, remember to give us you address details below.
Would you like us to include your name on our Save the Bogs gift catalogue mailing list? (Our catalogue is sent out free of charge in September every year to interested supporters) (Y/N):
If you answer yes, remember to give us you address details below.
What do you feel are the greatest threats facing our natural environment?
Details:
What interests do you have? (e.g art, theater, cinema, gardening, walking, sport etc>)
Details:
What environmental issues concern you the most? (Choose as many as you like - but only those that really concern you - and rank them in order of importance, 1 most important, 2 less important etc.)
Global warming:
Species in danger:
Habitat protection:
Rain forests:
Whale conservation:
Sustainable development:
Transport & roads:
Third world debt:
Development issues:
Woodland conservation:
Overgrazing of bogland:
Peatland destruction:
Other issues/ comments you would like to
make:
What is you favorite animal & plant?
Animal:
Plant:
Personal profile
Your name (optional - though if you wish us to send on your free copy of Rua or contact you again we will need this information e.g. Ms Jane Doe):
Your address (optional - though if you wish us to send on you free copy of Rua or contact you again we will need this information):
Country:
Your E-mail address:
Your sex: (M/F)
Your date of birth:
Educational qualification:
Secondary school (Y/N):
University/Higher level (Y/N):
Postgraduate (Y/N):
If you have asked us to send you any information remember that we need your full postal address and name to be able to send it to you - so don't forget to complete those sections.
Thank you for taking the time to complete this form and tell us about your concerns, experiences and about yourself. All the information will be treated in the strictest confidence.