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* 1. Full Name

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* 2. Postcode

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* 3. Gender

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* 4. Age

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* 5. Are you employed?

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* 6. Which ethnicity are you? Based on classification as per the Office of National Statistics

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* 7. How would you like to be involved in a focus group?

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* 8. Are there areas of the Council you would be more interested in than others?

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* 9. Email address  - for use as part of the focus group only

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* 10. Phone number  - for use as part of the focus group only

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* 11. This is a new project and we would welcome any other suggestions you have for how this could run  - Many thanks

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