Want to Live in Wolseley?

Having had more than my share of negative experiences in the Wolseley area, I am convinced that such a questionnaire will soon be required of each resident:

In accordance with the Neighborhood Character Preservation Act By-Law of 2011, the City of Winnipeg now requires each current and prospective resident of the Wolseley area to submit this questionnaire and forward it to the Social and Demographic Registry. Please answer all questions and return a signed copy to the Registrar, Social and Demographic Registry, 510 Main Street, Winnipeg, MB R3B 1B9.

Section I: Personal Information

Name ______________________________________________________________

Current Address ____________________________________________________

                        ____________________________________________________

                        ____________________________________________________

Phone Number    ____________________________________________________

E-mail Address    ____________________________________________________

If you are prospective resident of the Wolseley area, please state address of proposed residence:

                        ____________________________________________________

                        ____________________________________________________

                        ____________________________________________________

Social Insurance Number ______________________

Section II: Demographic Information

How many dogs do you own?

___ 2

___ 3

___ 4

___ more than 4

Which party did you vote for in the last election?

___ NDP

___ Green

___ Communist

___ Marxist-Leninist

___ Rhinoceros

___ Didn’t vote (incarcerated)

___ Didn’t vote (physically incapacitated)

___ Didn’t vote (other)

What is your occupation?

___ Environmentalist

___ Lobbyist

___ Social Activist

___ Child Care Worker

___ Social Worker

___ Bleeding Heart Socialist

___ Tree Hugger

___ Prostitute/Sex-trade Worker

___ Pimp/Sex-trade Broker

___ Drug Dealer

___ Car Thief

___ Slum Landlord

___ Hoodlum

___ Welfare Bum

___ Unemployed

Favorite recreational activities (check all that apply)

___ Illegally jogging on roadway

___ Snorting/selling crack cocaine

___ Ingesting/selling methamphetamines

___ Injecting/selling heroin

___ Smoking/selling marijuana

___ Swearing

___ Complaining

___ Protesting

___ Whining

___ Stealing cars

___ Vandalism (cars)

___ Vandalism (other)

___ Civil disobedience

___ Feeling sorry for the underprivileged

I have read and understand the Neighborhood Character Preservation Act, and I further understand that it is a serious offense to violate the Act and to have been untruthful in this questionnaire. As a condition of my acceptance for residency in the Wolseley area, I agree to periodic monitoring of my activities by the Registrar of the Social and Demographic Registry and/or his/her designate to ensure compliance with the Act. This may include, but not limited to the following: visual surveillance, wire tap of telephone conversations, sniffing Internet network traffic, periodic polygraph testing, and examining Manitoba Health and prescription records.

Signed at ________________ on this _____ day of ______________, _________.

_______________________________________

Signature of resident (or prospective resident)

_______________________________________

Signature of Witness (must not be blood relative of resident/prospective resident)

Name of Witness (please print) ______________________________

Address of Witness ____________________________________________________

                            ____________________________________________________

                            ____________________________________________________

Phone Number of Witness ______________________________________________