Stamford Hill Area Action Plan: Main Modifications Consultation - Part A - Personal details - Hackney Council

Are you taking part in this consultation as an individual or representing an organisation?

(Required) Individual / member of the public Voluntary or community sector organisation Local authority Councillor Agent of another organisation Other: (If other, please specify)

Other (please specify):

About You Section

The questions below are optional and will not be used in a way that identifies you.

This information will help us to understand our service users and residents, allowing us to establish if the response to the questionnaire is representative of the borough. All information is used under the strict controls of the 1998 Data Protection Act and the 2016 General Data Protection Regulations (GDPR).

Disability: Under the Equality Act you are disabled if you have a physical or mental impairment that has a 'substantial' and 'long-term' negative effect on your ability to do normal daily activities. Do you consider yourself to be disabled?

Yes No

Caring responsibilities: A carer is someone who spends a significant proportion of their time providing unpaid support to a family member, partner or friend who is ill, frail, disabled or has mental health or substance misuse problems. Do you regularly provide unpaid support caring for someone?

Yes No

Ethnicity: Are you...

Asian or Asian British White or White British Black or Black British Mixed background Other ethnic group

Other (please state if you wish):

Religion or belief: Are you or do you have...

Atheist/no religious belief Christian Muslim Buddhist Hindu Secular beliefs Charedi Jewish Sikh

Other (please state if you wish):

Sexual orientation: Are you...

Heterosexual Bisexual Gay man Lesbian or Gay woman Pansexual Asexual Queer All other sexual orientations Prefer not to say

Other (please state if you wish):

Housing Tenure: Which of the following best describes the ownership of your home?

Being bought on a mortgage Owned outright Rented (Local Authority/Council) Rented (Housing Association/Trust) Rented (private) Shared ownership (part rent/part buy) Temporary accommodation No permanent address Don’t know