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Rachel Hopkins MP - Luton South Summer Survey
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1.
Personal Information
Rachel Hopkins MP will use the results from this survey to support her work in Parliament. To learn more about how her office will process and store personal data, please read the
privacy notice
.
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1.
Question 1.
First name
Required
- Required.
*
2.
Question 2.
Surname
Required
- Required.
*
3.
Question 3.
What is your age range?
Required
- Required.
Under 18
18 to 24
25 to 29
30 to 34
35 to 39
40 to 44
45 to 49
50 to 54
55 to 59
60 to 64
65 to 69
70+
*
4.
Question 4.
Email address
Required
- Required.
*
5.
Question 5.
What is your postcode?
Required
- Required.
6.
Question 6.
What is your gender?
Male
Female
Non-binary
Prefer not to say
Prefer to self-describe
This is required
7.
Question 7.
What is your ethnicity?
British
Irish
Other
Indian
Pakistani
Bangladeshi
Any other Asian background
White and Black Caribbean
White and Black African
White and Asian
Any other mixed background
Caribbean
African
Any other Black background
Chinese
Any other Ethnic Group
I do not wish to disclose my ethnic origin
8.
Question 8.
Do you have a disability?
Yes
No
Prefer not to say