CSR Index Citizen This questionnaire inquires a rate of your personal social responsibility. Factual data: Socioeconomic data? Gender: ❍ Man ❍ Female ❍ Other Year of birth: Domicile: ❍ Town ❍ Village Job position/ Source of income: ❍ Employee ❍ Self-employed ❍ Unemployed ❍ Student ❍ Maternal / Parental leave ❍ Pensioner Current social role (Multiple answers): ❏ Student ❏ Working parent ❏ Parent without income from employment or self-employment ❏ Working pensioner ❏ Pensioner (including disability pensioner) ❏ Widow / Widower ❏ Childless in a relationship ❏ Childless and without a relationship In the following questionnaire, please tick in each question one answer only, unless stated otherwise. SCORING A A) The values generally accepted as desirable by the society you live in 1) Do you feel responsible for the quality of life? (Multiple answers) ❏ Yes, I feel responsible for the quality of my own life ❏ Yes, I feel responsible for the quality of life of my immediate surroundings ❏ Yes, I feel responsible for the quality of life of the whole world ❏ No 2) Do you really try to behave according to these values in a responsible manner? (Multiple answers) ❏ Yes, I do it ❏ Yes, I lead my surroundings to it ❏ No 3) Are you actively interested in the information in the area of socially responsible conduct? ❍ Yes ❍ No 4) Do you really live in compliance with the values of this society? ❍ Yes ❍ Rather yes ❍ Sometimes yes, sometimes no ❍ Rather no ❍ No 5) Do you fulfil the commitments resulting from the roles / functions of your life in a responsible manner? 5a) Job role ❍ Yes ❍ Rather yes ❍ Sometimes yes, sometimes no ❍ Rather no ❍ No 5b) Personal role ❍ Yes ❍ Rather yes ❍ Sometimes yes, sometimes no ❍ Rather no ❍ No 6) Do you accept feedback (even critical) from your surroundings? ❍ Yes, I do and think about it ❍ Yes, I hear it out ❍ No 7) Have you done any good deed in last 3 months? (Estimate how often) ❍ Yes, once a day ❍ Yes, once a week ❍ Yes, once a month ❍ No 8) Do you pay attention to and solve unfair (immoral, dishonest) conduct? ❍ Yes, I do and try to sort it out ❍ Yes, I do but I do not sort it out ❍ No, I do not and do not sort it out. 9) Do you have any voluntary role or function in public life? (E.g. a volunteer fireman, a volunteer worker of the Maltese Assistance, a member of the Red Cross, a chief of the children's camp, a coach, a member of the municipal council…) ❍ Yes ❍ No If your answer is „Yes“: 9a) I am engaged in public functions / roles: ❍ I actively fulfil all obligations resulting from the function/s. ❍ I accepted the function as a formal obligation only. SCORING B) Economic part B1) Economic self-sufficiency 1) Do you only spend as much as you can afford? ❍ Yes ❍ No 2) Do you fulfil your financial commitments? ❍ Yes ❍ No 3) Do you continuously keep track of your finances? ❍ Yes ❍ No 4) Do you maintain your personal budget with balanced incomes and expenses on a long-term basis? ❍ Yes ❍ No 5) Do you create financial reserves for you and your family just for crisis situations? ❍ Yes ❍ No B2) Buying habits 6) Do you read the notes on the products promoting a support to the good deed (no child labour, not tested on animals, fair-trade, support to the non-profit organizations, support to charity, etc.). ❍ Yes ❍ No 7) Do you prefer regional products? ❍ Yes ❍ No 8) Do you buy such amount of products and services you really need? ❍ Yes ❍ No 9) Have you advised somebody to buy a product or service of some company because it is socially responsible? ❍ Yes ❍ No 10) Have you advised somebody not to buy a product or service of some company because it does not behave with social responsibility? ❍ Yes ❍ No 11) Have you boycotted a product of any company in protest against it? ❍ Yes ❍ No C) Social area C1) Philanthropy 1) Have you donated your property, finances or your personal time to the good deed? ❍ Yes ❍ No 2) Do you participate in the public life of the municipality / town you live in? (culture, sport, ball, community) ❍ Yes ❍ No 3) Do you take part in the socially responsible activities of the municipality / town you live in? (collection, charity, municipality clean-up) ❍ Yes ❍ No 4) Which manifestations of discrimination do you consider unacceptable? (Multiple answers) ❏ Discrimination of women ❏ Discrimination of ethnical groups ❏ Discrimination of disabled persons ❏ Discrimination of senior citizens ❏ Sexual discrimination ❏ Religious discrimination ❏ Discrimination of homeless individuals ❏ Discrimination of the economically weak groups of citizens ❏ Discrimination of not adaptable citizens ❏ Others or ❏ None C2) Self-education 5) Do you educate yourself in some field with a concrete goal? ❍ Yes ❍ No 6) Do you educate yourself in the form of self-education? ❍ Yes ❍ No 7) Do you educate yourself in courses? ❍ Yes ❍ No 8) Do you pursue your personal development purposefully and on a long-term basis? ❍ Yes ❍ No C3) Healthy lifestyle 9) Do you care of your health? ❍ Yes ❍ Rather yes ❍ Rather no ❍ No 10) Do you try to stop stress situations in your life? ❍ Yes ❍ Rather yes ❍ Rather no ❍ No 11) Is your daily (according to your opinion) rest sufficient with respect to your workload? ❍ Yes ❍ No 12) Do you attend medical routine check-ups? ❍ Yes ❍ Rather yes ❍ Rather no ❍ No 13) Do you watch your body weight? ❍ Yes ❍ Rather yes ❍ Rather no ❍ No D) Environmental area (Multiple answers) 1) How much responsible are you towards the environment? ❏ I do not litter ❏ I do not buy bottled water, unless I have to ❏ I try not to waste energies ❏ I use public transport as often as possible ❏ I walk as much as possible ❏ I walk on the marked pathways (do not step on grass areas) ❏ I keep tidy the closest surrounding of my home ❏ Others or ❏ I do not address the environment. 2) How actively do you look after the environment in your private life? (Multiple answers) ❏ I separate waste ❏ I collect litters strewed around ❏ I drink tap water ❏ I purposefully save energy (by buying cost-effective appliances, placing gauges, etc.) ❏ I prefer transport with alternative energy sources (own and public) ❏ I purposefully safe water (using non-potable water, water savers in toilettes/taps) ❏ I prefer heating which does not harm the environment ❏ I plant greenery and look actively after that in my surroundings, where possible (trees, bushes, …) ❏ I actively improve the nearest surroundings of my home ❏ Others or ❏ I do not actively care about the environment 3) Do you pay some voluntary financial amount (beyond the scope of compulsory payments) to support the environment? ❍ Yes ❍ No 4) Are you interested in the news from the area of the environment? ❍ Yes, I am and I use it ❍ Yes, I am interested ❍ No