2. First Name
3. Last Name
5. Business Name
7. Email
9. Daytime Phone
10. Fax
12. Address
14. City
15. State
16. Zip Code
20. I feel safe in my home.

    1. Strongly Agree
    2. Agree
    3. Disagree
    4. Strongly Disagree
22. I feel safe walking in my neighborhood.

    1. Strongly Agree
    2. Agree
    3. Disagree
    4. Strongly Disagree
24. We should spend tax dollars on youth crime prevention programs such as D.A.R.E.

    1. Strongly Agree
    2. Agree
    3. Disagree
    4. Strongly Disagree
26. I believe that a lot of crimes in Papillion are committed by organized gangs.

    1. Strongly Agree
    2. Agree
    3. Disagree
    4. Strongly Disagree
28. I would be interested in being part of Neighborhood Watch.

    If interested in this program, please complete the contact information above.

    1. Yes
    2. No
32. How would you rate the overall quality of the service the Papillion Police Department provides?

    1. Excellent
    2. Good
    3. Adequate
    4. Poor
34. How would you rate the professional conduct, appearance and attitude of Papillion Police officers?

    1. Excellent
    2. Good
    3. Adequate
    4. Poor
36. Please rate the overall competency of Papillion Police Department employees.

    1. Excellent
    2. Good
    3. Adequate
    4. Poor
40. Within the last year, do you think that crime in your neighborhood has:

    1. Increased
    2. Decreased
    3. Stayed about the same
42. Police should focus their current speed enforcement efforts on:

    1. Heavily traveled roadways such as 84th Street, Cornhusker Road, etc.
    2. Residential roadways such as neighborhood streets, etc.
    3. Common areas such as parks
44. Please list any concerns with regard to law enforcement as it applies to the safety and security of you, friends, family or workplace.
46. Feel free to provide any recommendations, suggestions or additional information on how we can better serve the citizens of the community.
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48. 1. Receive an email copy of this form.
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