               (name of office deleted for obvious reasons)
                       Protester Satisfaction Survey

                                                   (standard form #27B/j)

Please take a few minutes to fill out this questionaire.  All answers will
be kept confidental and are used only for research purposes.

1: How did you hear about us? ____________________________________________

2: Did you enjoy your overall experience today?  __ Yes  __ No
    If not, why not? _____________________________________________________
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3: Is this your first protest with this (office)? __ Yes  __ No

4: On a scale of 1 to 10, please rate the following aspects of our service:

  (circle one)

    Representative accessibility    1 2 3 4 5 6 7 8 9 10

    Employee politeness/patience    1 2 3 4 5 6 7 8 9 10

    Toilet availability             1 2 3 4 5 6 7 8 9 10

    Snacks                          1 2 3 4 5 6 7 8 9 10

    Parking                         1 2 3 4 5 6 7 8 9 10


5: Would you come back and protest again?  __ Yes  __ No

6: What can we do to make future protests more fulfilling? _______________
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Thank you for your time.  Your answers will help (this office) become more
responsive to protester needs as part of our service goals.


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