home | your account | register |
log off
home
|
your account
|
register
|
log off
our services
find a home
rent
repairs
customer info
accessibility
sitemap
contact us
Join the 100 Club!
simply fill in and submit the questionnaire below
:
intouch 100 club questionnaire
New intouch 100 club questionnaire form entry
please choose the way(s) you would like to give us your views:
1 Questionnaires
2 Telephone Surveys
3 Focus Groups
4 @home Newsletters
5 Customer Inspections
6 Home Visits
7 E-Mail or Text
your name
your address
postcode
telephone
mobile
email address
what is the best time to contact you? (please tick)
Am
Pm
Evening
I would describe myself as: (please tick)
gender
Male
Female
age
16-25
26-55
56-65
66+
ethnicity
White British
White Irish
White Other
Mixed White & Caribbean
Mixed White & Black African
Mixed White & Asian
Mixed Other
Indian
Pakistani
Bangladeshi
Asian Other
Black Caribbean
Black African
Black Other
Chinese
Other
do you consider yourself to be a disabled person? (please tick)
Yes
No
employment status (please tick)
Full Time Employed
Part Time Employed
Self Employed
Studying
Unemployed
Other
which local management trust area do you live in
Aire-Wharfe
Bradford West City
East Bradford
North Bradford
Shipley
South Bradford
Dont Know
Submit