{"id":708,"date":"2013-03-13T11:59:32","date_gmt":"2013-03-13T11:59:32","guid":{"rendered":"http:\/\/onenorbiton.org.uk\/?page_id=708"},"modified":"2024-10-27T08:03:21","modified_gmt":"2024-10-27T08:03:21","slug":"confidentialenquiry","status":"publish","type":"page","link":"https:\/\/onenorbiton.org.uk\/?page_id=708","title":{"rendered":"Confidential Enquiry"},"content":{"rendered":"\n<p><\/p>\n\n\n<pre><strong><em>This form can be automatically translated into many different languages by clicking our translate service on the Home page<\/em><\/strong><\/pre>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td>\n<table style=\"height: 128px;\" width=\"643\">\n<tbody>\n<tr>\n<td>\n<h6><strong>A\u00a0\u00a0new European privacy law called GDPR, or General Data Protection Regulation, came into force on 25 May 2018. The GDPR regulates how organisations may use, store, and delete personal data. In order to remain transparent about how we process your personal data, we are taking this opportunity to reaffirm how your data will be processed and we are inviting you to decide if you wish to continue receiving email correspondence from One Norbiton<\/strong><\/h6>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<table width=\"602\">\n<tbody>\n<tr>\n<td>\n<table width=\"602\">\n<tbody>\n<tr>\n<td>\n<h6><strong>Names and email address will be held electronically by One Norbiton unless contacts do not wish us to do so. They can unsubscribe at any time by following the link on our website\u00a0<a href=\"http:\/\/www.onenorbiton.org.uk\/\">www.onenorbiton.org.uk<\/a><\/strong><\/h6>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h1><strong>Please help by sharing your ideas\u00a0with us<\/strong><\/h1>\n<p><strong>We hope to make our ward into one of the friendliest and best places to live, work and study. \u00a0<\/strong><b>So \u00a0if\u00a0<\/b><span style=\"font-weight: 600;\">you&#8217;d<\/span><b> like to build up the community feeling here, please fill in this form.<\/b><\/p>\n<form id=\"form_Confidential\" action=\"http:\/\/onenorbiton.org.uk\/conf.php\" method=\"post\">\n<table border=\"0\"><colgroup> <col width=\"33%\" \/> <col width=\"10%\" \/><\/colgroup>\n<tbody>\n<tr>\n<td>\n<p><strong>YOUR \u00a0POST CODE (E.G. 61 KT1 3JG)<\/strong><\/p>\n<\/td>\n<td><strong><input id=\"HomeCode\" maxlength=\"10\" name=\"HomeCode\" type=\"text\" value=\"\" \/><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<tr>\n<td><strong>1. Can you read and understand English?<\/strong><\/td>\n<td style=\"text-align: left;\"><strong><label>Yes <input name=\"English\" type=\"radio\" value=\"Yes\" \/><\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"English\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>2. If not, would you like help answering this questionnaire?<\/strong><\/td>\n<td><strong><label>Yes <input name=\"Help\" type=\"radio\" value=\"Yes\" \/><\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"Help\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>3. Have you tried our Website translator?<\/strong><\/td>\n<td style=\"text-align: left;\"><strong><label>Yes <input name=\"Translator\" type=\"radio\" value=\"Yes\" \/><\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"Translator\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>4. Are you happy to be our consultant?<\/strong><\/td>\n<td><strong><label>Yes <input name=\"Consultant\" type=\"radio\" value=\"Yes\" \/><\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"Consultant\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>5. What is your date of birth?<\/strong><\/td>\n<td><strong><input id=\"DOB\" maxlength=\"10\" name=\"DOB\" type=\"text\" value=\"\" \/><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>6a. Your first name or initial?<\/strong><\/td>\n<td><strong><input id=\"Fname\" maxlength=\"10\" name=\"Fname\" type=\"text\" value=\"\" \/><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>6b. Your \u00a0Family name ?<\/strong><\/td>\n<td><strong><input id=\"Lname\" maxlength=\"10\" name=\"Lname\" type=\"text\" value=\"\" \/><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>7. Please click if you are<\/strong><\/td>\n<td><strong><label>Male <input name=\"Gender\" type=\"radio\" value=\"Male\" \/><\/label><\/strong><\/td>\n<td><strong><label>Female <input name=\"Gender\" type=\"radio\" value=\"Female\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>8. What year did you start living in Norbiton?<\/strong><\/td>\n<td><strong><input id=\"Year\" maxlength=\"10\" name=\"Year\" type=\"text\" value=\"\" \/><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>9. How many years do you expect to stay here?<\/strong><\/td>\n<td><strong><input id=\"Stay\" maxlength=\"10\" name=\"Stay\" type=\"text\" value=\"\" \/><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>10. Who owns your house?<\/strong><\/td>\n<td><strong><label>Local Authority <input name=\"House\" type=\"radio\" value=\"LocalAuthority\" \/><\/label><\/strong><\/td>\n<td><strong><label>Right to Buy Freeholder <input name=\"House\" type=\"radio\" value=\"RightToBuyF\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Private Rented <input name=\"House\" type=\"radio\" value=\"PrivateRented\" \/><\/label><\/strong><\/td>\n<td><strong><label>Owner Occupier <input name=\"House\" type=\"radio\" value=\"OwnerOccupier\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Housing Association <input name=\"House\" type=\"radio\" value=\"HousingAssociation\" \/><\/label><\/strong><\/td>\n<td><strong><label>Other <input id=\"otherhouse\" maxlength=\"25\" name=\"otherhouse\" type=\"text\" value=\"\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Don&#8217;t know or rather not say <input name=\"House\" type=\"radio\" value=\"NotSay\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>11. How many generations live in your household?<\/strong><\/td>\n<td><strong><label>1 <input name=\"Generation\" type=\"radio\" value=\"1\" \/><\/label><\/strong><\/td>\n<td><strong><label>2 <input name=\"Generation\" type=\"radio\" value=\"2\" \/><\/label><\/strong><\/td>\n<td><strong><label>3 <input name=\"Generation\" type=\"radio\" value=\"3\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>12. What is your Employment Status?<\/strong><\/td>\n<td><strong><label>Full Time Employed <input name=\"Employment\" type=\"radio\" value=\"FullTime\" \/><\/label><\/strong><\/td>\n<td><strong><label>Part Time Employed <input name=\"Employment\" type=\"radio\" value=\"PartTime\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Self Employed <input name=\"Employment\" type=\"radio\" value=\"SelfEmployed\" \/><\/label><\/strong><\/td>\n<td><strong><label>Retired <input name=\"Employment\" type=\"radio\" value=\"Retired\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Unemployed <input name=\"Employment\" type=\"radio\" value=\"Unemployed\" \/><\/label><\/strong><\/td>\n<td><strong><label>Student\/In Training <input name=\"Employment\" type=\"radio\" value=\"Student\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Other<br \/><\/label><\/strong><br \/><strong><input id=\"other\" maxlength=\"25\" name=\"otheremployment\" type=\"text\" value=\"\" \/><\/strong><\/td>\n<td><strong><label>Don&#8217;t know or rather not say <input name=\"Employment\" type=\"radio\" value=\"NotSay\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>13. Do you often feel lonely?<\/strong><\/td>\n<td><strong><label>Yes <input name=\"Lonely\" type=\"radio\" value=\"Yes\" \/><\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"Lonely\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>If yes, whom can you rely on for support if things go wrong?<\/strong><\/td>\n<td><strong><label>My spouse or partner <input name=\"Support[]\" type=\"checkbox\" value=\"Partner\" \/><\/label><\/strong><\/td>\n<td><strong><label>My Family <input name=\"Support[]\" type=\"checkbox\" value=\"Family\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>My Friends <input name=\"Support[]\" type=\"checkbox\" value=\"Friends\" \/><\/label><\/strong><\/td>\n<td><strong><label>My Neighbours <input name=\"Support[]\" type=\"checkbox\" value=\"Neighbours\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>My Church <input name=\"Support[]\" type=\"checkbox\" value=\"Church\" \/><\/label><\/strong><\/td>\n<td><strong><label>Voluntary Agencies <input name=\"Support[]\" type=\"checkbox\" value=\"Agencies\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Social Services <input name=\"Support[]\" type=\"checkbox\" value=\"SocialServices\" \/><\/label><\/strong><\/td>\n<td><strong><label>Others<br \/><\/label><\/strong><br \/><strong><input id=\"other\" maxlength=\"25\" name=\"othersupport\" type=\"text\" value=\"\" \/><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>14. Do you often feel worried or under a lot of stress?<\/strong><\/td>\n<td><strong><label>Yes <input name=\"Stress\" type=\"radio\" value=\"Yes\" \/><\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"Stress\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>If yes, what causes it (Please tick all answers that apply to you)?<\/strong><\/td>\n<td><strong><label>Poor health or disability <input name=\"Cause[]\" type=\"checkbox\" value=\"PoorHealth\" \/><\/label><\/strong><\/td>\n<td><strong><label>Fear of attack by strangers <input name=\"Cause[]\" type=\"checkbox\" value=\"Attack\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Family problems e.g. divorce\/separation <input name=\"Cause[]\" type=\"checkbox\" value=\"FamilyProblems\" \/><\/label><\/strong><\/td>\n<td><strong><label>Refugee from my homeland <input name=\"Cause[]\" type=\"checkbox\" value=\"refugee\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Conflicts with neighbours <input name=\"Cause[]\" type=\"checkbox\" value=\"Neighbours\" \/><\/label><\/strong><\/td>\n<td><strong><label>Debt <input name=\"Cause[]\" type=\"checkbox\" value=\"Debt\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Change in benefits <input name=\"Cause[]\" type=\"checkbox\" value=\"BenefitsChange\" \/><\/label><\/strong><\/td>\n<td><strong><label>Addictions to alcohol etc <input name=\"Cause[]\" type=\"checkbox\" value=\"Addictions\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Other <input id=\"other\" maxlength=\"25\" name=\"otherworried\" type=\"text\" value=\"\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>14b. What health problems do you have now<\/strong><br \/><strong>(Please tick all that apply to you)<\/strong><\/td>\n<td><strong><label>Mobility <input name=\"health[]\" type=\"checkbox\" value=\"Mobility\" \/><\/label><\/strong><\/td>\n<td><strong><label>Mental Health <input name=\"health[]\" type=\"checkbox\" value=\"MentalHealth\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Blood Pressure <input name=\"health[]\" type=\"checkbox\" value=\"BloodPressure\" \/><\/label><\/strong><\/td>\n<td><strong><label>Heart <input name=\"health[]\" type=\"checkbox\" value=\"Heart\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Ashthma\/Bronchitis <input name=\"health[]\" type=\"checkbox\" value=\"Ashthma\/Bronchitis\" \/><\/label><\/strong><\/td>\n<td><strong><label>Indigestion <input name=\"health[]\" type=\"checkbox\" value=\"Indigestion\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Dental <input name=\"health[]\" type=\"checkbox\" value=\"Dental\" \/><\/label><\/strong><\/td>\n<td><strong><label>Blood <input name=\"health[]\" type=\"checkbox\" value=\"Blood\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Cancer <input name=\"health[]\" type=\"checkbox\" value=\"Cancer\" \/><\/label><\/strong><\/td>\n<td><strong><label>Deafness <input name=\"health[]\" type=\"checkbox\" value=\"Deafness\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Vision <input name=\"health[]\" type=\"checkbox\" value=\"Vision\" \/><\/label><\/strong><\/td>\n<td><strong><label>Kidney <input name=\"health[]\" type=\"checkbox\" value=\"Kidney\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Reproductive <input name=\"health[]\" type=\"checkbox\" value=\"Reproductive\" \/><\/label><\/strong><\/td>\n<td><strong><label>Other <input id=\"other\" maxlength=\"25\" name=\"otherhealth\" type=\"text\" value=\"\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>15. If in Debt do you have an expensive high interest Payday Loan?<\/strong><\/td>\n<td><strong><label>Yes <input name=\"PayDay\" type=\"radio\" value=\"Yes\" \/><\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"PayDay\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>16. Do you ever have to choose between paying for food or heating your home?<\/strong><\/td>\n<td><strong><label>Yes <input name=\"Food-Heat\" type=\"radio\" value=\"Yes\" \/><\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"Food-Heat\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>17. We are lucky that a Credit Union called &#8220;Boom&#8221; operates in Norbiton. This offers borrowing and saving at a fair rate of interest. Would you like to learn more about it?<\/strong><\/td>\n<td><strong><label>Yes <input name=\"SurreySave\" type=\"radio\" value=\"Yes\" \/><\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"SurreySave\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td colspan=\"3\">\n<p><strong>18. How happy or unhappy, in general, do you feel about living in Norbiton now? \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<\/strong><strong>Click the button under the face below to record \u00a0<a href=\"http:\/\/onenorbiton.org.uk\/wp-content\/uploads\/FULL-FACES-PAPER.pdf\">how you&#8217;re feeling<\/a>.<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table style=\"height: 119px;\" width=\"644\">\n<tbody>\n<tr>\n<td><strong><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"..\/..\/smile0.jpg\" alt=\"\" width=\"30\" height=\"30\" \/><\/strong><\/td>\n<td><strong><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"..\/..\/smile10.jpg\" alt=\"\" width=\"30\" height=\"30\" \/><\/strong><\/td>\n<td><strong><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"..\/..\/smile20.jpg\" alt=\"\" width=\"30\" height=\"30\" \/><\/strong><\/td>\n<td><strong><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"..\/..\/smile30.jpg\" alt=\"\" width=\"30\" height=\"30\" \/><\/strong><\/td>\n<td><strong><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"..\/..\/smile40.jpg\" alt=\"\" width=\"30\" height=\"30\" \/><\/strong><\/td>\n<td><strong><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"..\/..\/smile50.jpg\" alt=\"\" width=\"30\" height=\"30\" \/><\/strong><\/td>\n<td><strong><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"..\/..\/smile60.jpg\" alt=\"\" width=\"30\" height=\"30\" \/><\/strong><\/td>\n<td><strong><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"..\/..\/smile70.jpg\" alt=\"\" width=\"30\" height=\"30\" \/><\/strong><\/td>\n<td><strong><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"..\/..\/smile80.jpg\" alt=\"\" width=\"30\" height=\"30\" \/><\/strong><\/td>\n<td><strong><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"..\/..\/smile90.jpg\" alt=\"\" width=\"34\" height=\"39\" \/><\/strong><\/td>\n<td><strong><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"..\/..\/smile100.jpg\" alt=\"\" width=\"35\" height=\"39\" \/><\/strong><\/td>\n<\/tr>\n<tr align=\"center\">\n<td><strong>0<\/strong><\/td>\n<td><strong>10<\/strong><\/td>\n<td><strong>20<\/strong><\/td>\n<td><strong>30<\/strong><\/td>\n<td><strong>40<\/strong><\/td>\n<td><strong>50<\/strong><\/td>\n<td><strong>60<\/strong><\/td>\n<td><strong>70<\/strong><\/td>\n<td><strong>80<\/strong><\/td>\n<td><strong>90<\/strong><\/td>\n<td><strong>100<\/strong><\/td>\n<\/tr>\n<tr align=\"center\">\n<td><strong><input name=\"happiness\" type=\"radio\" value=\"0\" \/><\/strong><\/td>\n<td><strong><input name=\"happiness\" type=\"radio\" value=\"10\" \/><\/strong><\/td>\n<td><strong><input name=\"happiness\" type=\"radio\" value=\"20\" \/><\/strong><\/td>\n<td><strong><input name=\"happiness\" type=\"radio\" value=\"30\" \/><\/strong><\/td>\n<td><strong><input name=\"happiness\" type=\"radio\" value=\"40\" \/><\/strong><\/td>\n<td><strong><input name=\"happiness\" type=\"radio\" value=\"50\" \/><\/strong><\/td>\n<td><strong><input name=\"happiness\" type=\"radio\" value=\"60\" \/><\/strong><\/td>\n<td><strong><input name=\"happiness\" type=\"radio\" value=\"70\" \/><\/strong><\/td>\n<td><strong><input name=\"happiness\" type=\"radio\" value=\"80\" \/><\/strong><\/td>\n<td><strong><input name=\"happiness\" type=\"radio\" value=\"90\" \/><\/strong><\/td>\n<td><strong><input name=\"happiness\" type=\"radio\" value=\"100\" \/><\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table><colgroup> <col width=\"33%\" \/> <\/colgroup>\n<tbody>\n<tr>\n<td><strong>19. Do you fear that delay in getting Universal Credit will stress you?<\/strong><\/td>\n<td><strong><label>Yes <input name=\"BedroomTax\" type=\"radio\" value=\"Yes\" \/><\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"BedroomTax\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>20. Even if you have problems of your own, do you feel you could enjoy life more by becoming a more helpful neighbour?<\/strong><\/td>\n<td><strong><label>Yes <input name=\"Helpful\" type=\"radio\" value=\"Yes\" \/><\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"Helpful\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>21. If so, do you think you can offer some informal personal help?<\/strong><\/td>\n<td><strong><label>Yes <input name=\"Personal\" type=\"radio\" value=\"Yes\" \/><\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"Personal\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>22. Are you caring or helping care for a child under the age of 5?<\/strong><\/td>\n<td><strong><label>Yes <input name=\"Child\" type=\"radio\" value=\"Yes\" \/><\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"Child\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>23. Do you sometimes feel you need help?<\/strong><\/td>\n<td><strong><label>Yes <input name=\"Needhelp\" type=\"radio\" value=\"Yes\" \/> <\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"Needhelp\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>24. Although most people want to volunteer to help their community, they worry about becoming over committed.So we are developing a form of \u2018drop in\u2019 volunteering, which will only involve you offering ideas or voting about our projects on line, Please tick which of our current projects interest you<\/strong><\/td>\n<td>\n<p><strong><label>Helping with our Tuesday Lunches for the Needy and Homeless\u00a0<input name=\"activities[]\" type=\"checkbox\" value=\"Rangers\" \/><\/label><\/strong><\/p>\n<p><strong><label><label>Joining a Neighbourhood Watch\u00a0<\/label> <input name=\"activities[]\" type=\"checkbox\" value=\"TaskForce\" \/><\/label><\/strong><\/p>\n<p><strong><label><label><label>Doing Drop-in Volunteering<\/label><\/label><input name=\"activities[]\" type=\"checkbox\" value=\"Drop-inVolunteering\" \/><\/label><\/strong><\/p>\n<\/td>\n<td><strong><label>Running or attending Post-Code Tea parties\u00a0<input name=\"activities[]\" type=\"checkbox\" value=\"Energy\" \/><\/label><\/strong><br \/><strong><label>Joining Edemocracy <input name=\"activities[]\" type=\"checkbox\" value=\"Edemocracy\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<tr>\n<td><strong>25. What is your email address?<\/strong><\/td>\n<td><strong><input id=\"email\" maxlength=\"25\" name=\"email\" type=\"text\" value=\"\" \/><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>26a. What is your phone number?<\/strong><\/td>\n<td><strong><input id=\"phone\" maxlength=\"25\" name=\"phone\" type=\"text\" value=\"\" \/><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>26b. What is your mobile number?<\/strong><\/td>\n<td><strong><input id=\"mobile\" maxlength=\"25\" name=\"mobile\" type=\"text\" value=\"\" \/><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>27. Are you happy for One Norbiton to contact you by email or phone?<\/strong><\/td>\n<td><strong><label>Yes <input name=\"contact\" type=\"radio\" value=\"Yes\" \/><\/label><\/strong><\/td>\n<td><strong><label>No <input name=\"contact\" type=\"radio\" value=\"No\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>28. What is your ethnic group?<\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>A White<\/strong><\/td>\n<td><strong><label>British <input name=\"ethnic\" type=\"radio\" value=\"British\" \/><\/label><\/strong><br \/><strong><label>Irish <input name=\"ethnic\" type=\"radio\" value=\"Irish\" \/><\/label><\/strong><\/td>\n<td><strong><label>Any other White <input name=\"ethnic\" type=\"radio\" value=\"AnyWhite\" \/><\/label><\/strong><br \/><strong><label>Please tell us <input id=\"Please tell us\" maxlength=\"25\" name=\"ethnicother\" type=\"text\" value=\"\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>B Mixed<\/strong><\/td>\n<td><strong><label>White-Black Caribbean <input name=\"ethnic\" type=\"radio\" value=\"White-Black Caribbean\" \/><\/label><\/strong><br \/><strong><label>White-Black African <input name=\"ethnic\" type=\"radio\" value=\"White-Black African\" \/><\/label><\/strong><\/td>\n<td><strong><label>White-Asian <input name=\"ethnic\" type=\"radio\" value=\"White-Asian\" \/><\/label><\/strong><br \/><strong><label>Any other mixed <input name=\"ethnic\" type=\"radio\" value=\"anyothermixed\" \/><\/label><\/strong><br \/><strong><label>Please tell us <input id=\"Please tell us\" maxlength=\"25\" name=\"ethnicother1\" type=\"text\" value=\"\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>C Asian or Asian British<\/strong><\/td>\n<td><strong><label>Indian <input name=\"ethnic\" type=\"radio\" value=\"Indian\" \/><\/label><\/strong><br \/><strong><label>Pakistani <input name=\"ethnic\" type=\"radio\" value=\"Pakistani\" \/><\/label><\/strong><\/td>\n<td><strong><label>Bangladeshi <input name=\"ethnic\" type=\"radio\" value=\"Bangladeshi\" \/><\/label><\/strong><br \/><strong><label>Tamil <input name=\"ethnic\" type=\"radio\" value=\"Tamil\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Korean <input name=\"ethnic\" type=\"radio\" value=\"Korean\" \/><\/label><\/strong><br \/><strong><label>Any other Asian <input name=\"ethnic\" type=\"radio\" value=\"anyotherasian\" \/><\/label><\/strong><br \/><strong><label>Please tell us <input id=\"Please tell us\" maxlength=\"25\" name=\"ethnicother2\" type=\"text\" value=\"\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>D Black or Black British<\/strong><\/td>\n<td><strong><label>Caribbean <input name=\"ethnic\" type=\"radio\" value=\"Caribbean\" \/><\/label><\/strong><br \/><strong><label>African <input name=\"ethnic\" type=\"radio\" value=\"African\" \/><\/label><\/strong><\/td>\n<td><strong><label>Any other Black <input name=\"ethnic\" type=\"radio\" value=\"anyotherblack\" \/><\/label><\/strong><br \/><strong><label>Please tell us <input id=\"Please tell us\" maxlength=\"25\" name=\"ethnicother3\" type=\"text\" value=\"\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>E Chinese or other ethnic group<\/strong><\/td>\n<td><strong><label>Chinese <input name=\"ethnic\" type=\"radio\" value=\"Chinese\" \/><\/label><\/strong><\/td>\n<td><strong><label>Any other background <input name=\"ethnic\" type=\"radio\" value=\"anyotherchinese\" \/><\/label><\/strong><br \/><strong><label>Please tell us <input id=\"Please tell us\" maxlength=\"25\" name=\"ethnicother4\" type=\"text\" value=\"\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>29. What is your religion or belief?<\/strong><\/td>\n<td><strong><label>Christian <input name=\"religion\" type=\"radio\" value=\"Christian\" \/><\/label><\/strong><\/td>\n<td><strong><label>Buddhist <input name=\"religion\" type=\"radio\" value=\"Buddhist\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Hindu <input name=\"religion\" type=\"radio\" value=\"Hindu\" \/><\/label><\/strong><\/td>\n<td><strong><label>Sikh <input name=\"religion\" type=\"radio\" value=\"Sikh\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Jewish <input name=\"religion\" type=\"radio\" value=\"Jewish\" \/><\/label><\/strong><\/td>\n<td><strong><label>Muslim <input name=\"religion\" type=\"radio\" value=\"Muslim\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Atheist <input name=\"religion\" type=\"radio\" value=\"Atheist\" \/><\/label><\/strong><\/td>\n<td><strong><label>Agnostic <input name=\"religion\" type=\"radio\" value=\"Agnostic\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Other &#8211; Please tell us <input id=\"Please tell us\" maxlength=\"25\" name=\"religionother\" type=\"text\" value=\"\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>30. What is your sexual orientation?<\/strong><\/td>\n<td><strong><label>Heterosexual (Man and Woman) <input name=\"sex\" type=\"radio\" value=\"Heterosexual\" \/><\/label><\/strong><\/td>\n<td><strong><label>Lesbian <input name=\"sex\" type=\"radio\" value=\"Lesbian\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Gay <input name=\"sex\" type=\"radio\" value=\"Gay\" \/><\/label><\/strong><\/td>\n<td><strong><label>Bisexual <input name=\"sex\" type=\"radio\" value=\"Bisexual\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00a0<\/td>\n<td><strong><label>Other &#8211; Please tell us <input id=\"Please tell us\" maxlength=\"25\" name=\"religionother\" type=\"text\" value=\"\" \/><\/label><\/strong><\/td>\n<\/tr>\n<tr>\n<td colspan=\"3\" valign=\"top\"><strong>Please enter any comments you would like to make about making Norbiton a better place<\/strong><\/td>\n<\/tr>\n<tr>\n<td colspan=\"3\"><strong><textarea cols=\"50\" name=\"comments\" rows=\"3\"><\/textarea><\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"text-align: center;\"><strong><input id=\"Submit\" name=\"Submit\" type=\"submit\" value=\"Submit\" \/><\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/form>\n<p><strong><!--more--><\/strong><\/p>\n<p><strong><a name=\"TRANSLATE\"><\/a><span style=\"color: white;\">Translation<\/span><\/strong><\/p>","protected":false},"excerpt":{"rendered":"<p>This form can be automatically translated into many different languages by clicking our translate service on the Home page A\u00a0\u00a0new European privacy law called GDPR, or General Data Protection Regulation, came into force on 25 May 2018. The GDPR regulates how organisations may use, store, and delete personal data. In order to remain transparent about &hellip; <a href=\"https:\/\/onenorbiton.org.uk\/?page_id=708\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Confidential Enquiry&#8221;<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"jetpack_post_was_ever_published":false,"_mc_calendar":[],"two_page_speed":{"previous_score":{"status":"error_no_score"},"current_score":{"desktop_score":80,"desktop_tti":"0.6\u00a0","mobile_score":64,"mobile_tti":"2.7\u00a0","date":"27.10.2024 08:03:53 am","status":"error_no_score"}},"footnotes":""},"class_list":["post-708","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/P29YAy-bq","_links":{"self":[{"href":"https:\/\/onenorbiton.org.uk\/index.php?rest_route=\/wp\/v2\/pages\/708","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/onenorbiton.org.uk\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/onenorbiton.org.uk\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/onenorbiton.org.uk\/index.php?rest_route=\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/onenorbiton.org.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=708"}],"version-history":[{"count":119,"href":"https:\/\/onenorbiton.org.uk\/index.php?rest_route=\/wp\/v2\/pages\/708\/revisions"}],"predecessor-version":[{"id":3168,"href":"https:\/\/onenorbiton.org.uk\/index.php?rest_route=\/wp\/v2\/pages\/708\/revisions\/3168"}],"wp:attachment":[{"href":"https:\/\/onenorbiton.org.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=708"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}