Get involved Name*Address 1*Address 2City*Postcode*Telephone number*Additional numberE-mail addressDate of birth*MM/DD/YYYYHow would you describe your household?*Single elderly person (aged 75+)Elderly couple (at least one aged 75+)Single elderly person (aged 60+)Elderly couple (at least one aged 60+)Single adult (aged 16-59)Couple (both aged 16-59)Single person with at least one child under 16Couple with at least one child under 16Household with disabled members of the familyPlease tick a box from each section which best describes you*BritishEuropeanPakistaniBangladeshiIndianAfricanCaribbeanOf mixed ethnic originPlease tick a box from each section which best describes your partner*BritishEuropeanPakistaniBangladeshiIndianAfricanCaribbeanOf mixed ethnic originWhich areas are you interested in being consulted on? (tick up to three which are of most interest)* Allocations / Lettings Customer Care Rents / Charges / Rent Arrears Repairs / Major Works Community Safety Facilities for Young People Facilities for Disabled Facilities for the Elderly Clean and Tidy Environment Tenancy Conditions Equality & Diversity Do you need?Large PrintDisabled AccessChild CareTranslation to other languageOtherIf you selected "Translation to other language" or "Other" on the previous question, please specify:Which method of consultation would you prefer? (tick any that apply)* Large Print Questionnaire Focus Group Telephone Survey Meeting Email One to One Interview Tenants and Residents Group Newsletters/leaflets Text Message What is the best time for you to attend meetings? Morning Afternoon Evening If you have any other ideas about how we can involve tenants that have not been covered so far please give details below YOU WILL RECEIVE AN AUTOMATED ACKNOWLEDGEMENT FOR YOUR QUERY AND YOU CAN EXPECT A FULL RESPONSE WITH 10 WORKING DAYS OF RECEIPT.
