What is the wish of the community?
This form is used to go door to door and ask the citizens of the community what they would want to be different in the community. What would they want to see improved, changed? What ideas would they have? What would they need? What service could be offered to them?
Email address *
Email address *
Please repeat email address
Your answer
Your First name *
Your answer
MySPURT account number *
Required to receive 25 SPURT per inquiry.
Your answer
First and Last name of the person you are inquiring *
Your answer
Age of the person you are inquiring *
Please make sure you are not only asking people from your age.
Your answer
Explanation why you are working on this inquiry
In our community we are working on integrating a digital currency named SPURT, with which we can pay each other for goods and services. That would cause that there is "normal" money left to pay for other things. In our community center we organize meetings, where this currency is explained.
But not only that, we want our youth to get to work. We are looking for what they can DO to make the community better. We are looking for what they can do to make YOUR life better. They will get paid in SPURT but they also might earn (partly) in normal currency for the time being, for SPURT is not yet convertible.
To improve the quality of our community we want to ask you a few questions about what YOU would want to be different.
We cannot promise yet that your wish/idea will be fulfilled right away, but we promise to take your wish/idea serious.
First we start with your personal life
What is the one TOP thing you want to be changed in your own home? *
Do you also see a solution?
Your answer
The second most important thing that you would want to change in your own home. *
What would be the solution for that?
Your answer
Are there other things you would want to be changed in your own home over time? *
Your answer
Are there perhaps dangerous situations in your house that needs attention? *
Your answer
Would you need care or help to change something in/at your house? *
Perhaps to make life easier, to clean up, to renew something, missing/damaged furniture, help to go shopping or have someone that is doing shopping for you. Bring you to the hospital, stay with you when going to see a doctor. etc. Please describe your needs.
Your answer
What service would you like us to provide? *
What could we do for you to make your life easier, happier, more comforatble? Please take your time to think about it.
Your answer
How is your family situation? With how many people do you live in this house? *
person
person
Do you have a job? *
If we could offer you services, would you be willing and able to pay (at least partly) for the service? *
What could you afford to pay?
Your community
If you look around you, in the street, the community, what would you like to be changed? *
If you have any suggestion HOW to change it, please tell us. If we are gone and you suddenly get an idea, please come to the community center.
Your answer
We are planning to improve the community. Do you think you can add to that idea? If yes, how many hours a week could you assist? *
The ideal plan would be that you work 3,5 hours a week for your community for free. It can be in a shop, in taking care of others, in a factory, in cleaning the streets, whatever you think you can do. You would get paid in SPURT.
I canNOT help built my community one hour a week
I can and WILL help built my community ten hours or more a week
How would you like to contribute to your community? *
Think of the video: A small city can change the world. http://www.ubuntuparty.org.za/2017/01/one-small-town-will-change-world.html
Required
You might be unemployed. Would you be willing to stand up for your community and find that way possibilities to earn money and for sure SPURT? *
What do you like the most from this inquiry? *
Required
Do you want to provide a short description of what you mean with "other?
Your answer
Thank you very much for answering my questions.
I promise you that we will do all we can to improve your situation and that way help ourselves.
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