Environmental Awareness Local Community Survey Form
Full Name
Email Address
Age
Community / Area
How concerned are you about environmental issues in your community?
Very concerned
Somewhat concerned
Neutral
Not very concerned
Not at all concerned
Which environmental issues do you think are most important in your area? (Select all that apply)
Waste management
Air/Water pollution
Deforestation
Climate change
Water conservation
Other
Are you aware of any ongoing community efforts addressing environmental issues?
Yes
No
Have you participated in any environmental activities or programs in your community?
Yes
No
Suggestions to improve environmental awareness or action in your community
Additional comments or feedback