Castletown Living Streets

1. Do you live in the scheme area?

(Required) Yes No

If yes, please state the name of the street you live on:

2. What is your age group?

Under 16 16 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75+

3. What is your gender?

Female Male Prefer not to say Other

4. Are you responding on behalf of an organisation?

Yes (please specify) No

Organisation:

5. Do you have issues with mobility?

Yes (I am a blue badge holder) Yes (I am not a blue badge holder) No Prefer not to say

6. What best describes your occupation?

Full-time education Full-time employment Part-time employment Not in paid employment Retired Other (please specify)

Other:

7. May we publish your response?

Please read our Privacy Policy for more details and your rights.

Publish in full – your first name and surname, organisation name, along with full answers will be published on the hub (your email will not be published)
Publish anonymously – only your responses will be published on the hub (your name, organisation and email will not be published)
Do not publish – nothing will be published publically on the hub (your response will only be part of a larger summary response document)

(Required) Yes, you can publish my response in full Yes, you may publish my response anonymously No, please do not publish my response

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