Questionnaire (2 copies, to be filled out by safe guard and offender separately)

Equality takes on many forms, some more apparent than others. Often equality is inter-generational and it's forms passed down from grandparents, to parents and eventually continued generation by generation without thought or question. On the following questionnaire please check all items where this has occurred as a way of treating significant others equally. If you have seen your parents use any of these forms place a "P" in the column; if you use one of the following forms place a "S" in the column.

Non-Threatening Behavior:

Talking and acting so that he/she feels safe and comfortable

Expressing himself/herself and doing things

Respect:

Listening to him/her non-judgementally

Being emotionally affirming and understanding

Valuing opinions

Trust and Support:

Supporting his/her goals in life

Respecting his/her right to his/her own feelings, friends, activities, opinions

Responsible Parenting:

Sharing parental responsibilities

Being a positive non-violent role model for the children

Shared Responsibility:

Mutually agreeing on a fair distribution of work

Making family decisions together

Economic Partnership:

Making money decisions together

Making sure both partners benefit from financial arrangements

Negotiation and Fairness:

Seeking mutually satisfying resolutions to conflict

Accepting change

Being willing to compromise

Signature: _________________________________Date: ______________________