APPENDIX B - JURY MANAGEMENT FORMS

JURY SERVICE QUESTIONNAIRE

Your opinions and answers to the questions below will help us to improve jury service in Washington County. The statistical data, which will insure that we are providing a good cross section of jurors, is personal so we ask that you DO NOT SIGN your name. All responses are voluntary and confidential.

1. When you were first called as a juror, what was your reaction?
   Very pleased___ Pleased___ Displeased___ Very Displeased___

2. If you were called again, what would your reaction be?
   Very pleased___ Pleased___ Displeased___ Very Displeased___

3. How many times were you notified to appear on a case? ___times

4. Did you serve on a case? Yes_____ No______

5. how would you rate the following factors:(Please answer all)

   	EXCELLENT	GOOD	FAIR	POOR
   Treatment by Court Staff
   Physical Comfort
   Personal Safety
   use of Your Time

     6a:   What impressed you most about your jury experience?
              __________________________________________________

     6b:   Wash disappointed you most about your jury experience?
              __________________________________________________

     6c:   YES____ NO____ Jury service would be easier if I were called for
              multiple appearances in a three week period than several times
              over the year.

     6d:   In what ways do you think jury service could be improved?
              __________________________________________________
              (Please put any additional comments on back of form)

STATISTICAL INFORMATION

7. Age ________

8. Sex: Female/Male

9. Marital Status: Married__ Single__ Divorced__ Widow(er)__

10. Race: Black___ White___ Other(specify)_____________

11. Education Level: (circle the number of years completed.)
    Elementary and High School    College    Graduate School
    1 2 3 4 5 6 7 8 9 10 11 12          1 2 3 4      1 2 3 4 5 6 7 8

12. Occupation:________________________________________________

13. What is your total personal (not family) income: (check range below)
    
    less than $7000___ $16000 to $18999___ $28000 to $30999___
    $7000 to $9999 ___ $19000 to $21999___ $31000 to $39999___
    $10000 to $12999___ $22000 to $24999___ $40000 to $49999___
    $13000 to $15999___ $25000 to $27999___ $50000 and above___

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ALL RIGHTS RESERVED