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Home  Virtual Exhibits Resettlement Documents Petition: Questionnaire to be completed by the local resettlement committee
Petition: Questionnaire to be completed by the local resettlement committee
Questionnaire Image (106k)
RESETTLEMENT AREA
(To be completed by local Committee on each community to which residents will be moving.)
NAME OF COMMUNITY _________________________________________________
INTENDED NO. OF HOUSEHOLDERS _____________________________ (See petition)
1. Is medical attention available? ________________________________________________________
2. Is sufficient school space available? ___________________________________________________
3. Are Churches available? (Same faith as families moving in) _________________________________
4. Is Post Office, C.N.T., or telephone service available? ______________________________________
5. Is electricity available? ______________________________________________________________
6. Is sewerage and water available? _____________________________________________________
7. Other community services. ___________________________________________________________
8. Main sorces [sic] of employment. __________________________________________________________
9. Is there a Community Council? ________________________________________________________
10. Is there a Road connection? __________________________________________________________
11. Other comments. ___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
SIGNED:
Local Committee: __________________________________________
CHAIRMAN
__________________________________________
MEMBER
Date: ___________________________
__________________________________________
DAY
MONTH
YEAR
MEMBER
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