Residents Consultation Database Questionnaire

Dartford Borough Council is constantly looking for new and innovative ways to deliver better services.To ensure that the services we provide are relevant to your needs,we would like to know more about what you want.

If you want to be involved in reshaping the future of our services, please complete and return this form to be registered as an interested party. You will be entered into a prize draw for every time you get involved.

If you would like to find out more about resident involvement please contact our resident involvement team on 01322 343841 or email us.

Please note: Should you not want to take part in any consultation it will not affect your tenancy. All details held will be used solely by the Council for the purpose of consulting on Housing Services.

About you
Name
Address	Type your full address here, including the postcode
Phone
Mobile
Email
Are you currently involved with any resident/community groups?	Yes No
What topics are you most interested in? (tick as many as you want):	Community Safety & Anti-Social Behaviour Customer Service Environmental Services Equality and Diversity Homelessness Leasehold Management Performance Monitoring Planned Maintenance Sport and Leisure Provisions for Older People Regeneration and Dartford Town Centre Rent and Service Charges Repairs Resident Involvement Service Standards and Targets Tenancy Management Young People
Please tell us what area(s) most interest you:	Bean and Darenth Brent Castle Greenhithe Heath Joyce Green Joydens Wood Littlebrook Longfield, New Barn & Southfleet Newtown Princes Stone Sutton-at-Hone Swanscombe Temple Hill West Hill Wilmington
How would you like to be involved? (tick as many as you want)	By e-mail Postal surveys Telephone surveys Meeting with others in a focus group to discuss specific topics Taking part in meetings to look at documents and policies As a mystery shopper Other Please state:
To help us ensure that we operate fairly and to provide equality of opportunity so that members are a representative sample of our tenants, would you please answer the brief questions below?
Your household
Numbers of adults in household
Number of children in household
Ages of children
Tenant/leaseholder/freeholder
Could you please tell us about your working status?	Employed full time Employed part time Unemployed Parent/Carer Studying Retired
Your marital status	Single Married/Living with partner
Your gender	Male Female
Your age	Under 16 16-19 20-24 25-59 60-64 Over 65
How would you best describe your ethnic origin?	White British White Irish Any Other White Background White & Black Caribbean White & Black African White & Asian Any Other Mixed Background Indian Pakistani Bangladeshi Any Other Asian Background Black Caribbean Black African Any Other Black Background Chinese Any Other Ethnic Group Not Known
Your Nationality	UK National, Resident in the UK UK National, returning from Residence Oversees Czech Republic Estonia Hungary Latvia Lithuania Poland Slovakia Slovenia Other European (EEA) Country Any Other Nationality Prefer not to say
Do you consider yourself as having a disability?	Yes No If yes, do you have: Difficulty getting around Difficulty seeing Difficulty hearing Learning difficulty Mental health problems Other difficulty – please state:
If you are under the age of 16 years, please ensure you have your parents/guardians permission to take part in consultation	Parent/Guardian Name:

Dartford Borough Council

Residents Consultation Database Questionnaire

Website structure:

View properties:

Check (eCitizen service):

PDF Forms to download:

Documents and policies:

Contact: