Make a compliment or complaint

Your details
1. Name*
2. E-mail*
3. Telephone number
4. Address
5. Postcode
Label
1. Is the complaint on behalf of yourself or some one else? *
  1. Myself
  2. Someone else
Details of other person
1. Name
2. Address
3. Post Code
4. Telephone
5. E-Mail
Label
1. Your message (maximum 1000 characters)*
Equal Opportunities Monitoring
1. Under the Equality Act 2010, the council has a responsibility to ensure that it does not unfairly discriminate in the services it provides. In order to help us ensure that our Equal Opportunities policy is working, would you please provide the following information by ticking the appropriate boxes:
2. Sex/Gender Identity
3. Ethnic origin
4. Do you have a disability which affects your day to day activities, which has lasted or you expect to last at least a year?
5. Sexual orientation
6. Religion
7. How old are you?
8. This information will be treated in the strictest confidence and will only be used for statistical monitoring, to ensure our services are accessible to everyone.
10. Form ID: 194

Wolverhampton City Council