Cribbs Patchway MetroBus Extension

Public Consultation 27November 2015 to 15 January 2016

Please return to:FREEPOST RTCT-JXLE-EET, Strategic Transport Policy Team, MetroBus Extension consultation, South Gloucestershire Council, Civic Centre, High Street, Kingswood, Bristol, BS15 9TR.

or if in electronic form by emailing this form to uploading the form at

Responses must be received by or on Friday 15 January 2016

Name
Address
Post code
Email address
Telephone

If you are making a comment on a particular part of the Cribbs Patchway MetroBus Extension please ensure you clearly describe where.

Comment
Continue if necessary…
…continued

Are you responding as? (please tick)

A resident
A Parish or Town Council
A local voluntary or community organisation
A South Gloucestershire Councillor
A local business
A landowner or developer
Other, please state:

In any typical week, what forms of transport do you normally use to make journeys to places of work, education, shopping or leisure? (please tick all that apply):

Car
Bus
Bicycle
Train
Taxi
Community Transport
Walk/run
Motorbike/moped

DATA PROTECTION:

The information collected as part this consultation will also be used by the Council (and its delivery partners) in accordance with the data protection principles in the Data Protection Act 1998. The purposes for collecting this data are: to assist in plan making and project development; and to contact you, if necessary, regarding the consultation process. Your response may be made public as it will form part of the evidence base used to inform the decision making process, however personal information will be removed prior to any publication. The above purposes may require public disclosure of any data received, in accordance with the Freedom of Information Act 2000.

ABOUT YOU

This optional section about yourself is important as it helps us understand more about thepeople who use our services. The information you supply will help us ensure we understandthe views of different people. Any responses to these questions will remain confidential, individuals will not be identified and personal details will not be published.

Gender

Are you? (please tick)

Female
Male
Prefer not to say

Age

How old are you?

18 and under
19 – 24
25 – 44
45 – 64
65 – 74
75 and over
Prefer not to say

Disability

Do you consider yourself to be disabled?

Yes
No

If yes, please tell us how this affects the way that you access council services

Ethnicity

Please tell us your ethnic origin:

Arab
Asian/Asian British – Bangladeshi
Asian/Asian British – Indian
Asian/Asian British – Pakistani
Asian/Asian British – Chinese
Asian/Asian British – Other (please state):
Black/African/Caribbean/Black British – African
Black/African/Caribbean/Black British – Caribbean
Black/African/Caribbean/Black British – Other (please state)
Gypsy or Traveller
Mixed/Multiple Ethnic Groups – White & Asian
Mixed/Multiple Ethnic Groups – White & Black African
Mixed/Multiple Ethnic Groups – White & Black Caribbean
Mixed/Multiple Ethnic Groups – Other (please state)
White – English/Welsh/Scottish/Northern Irish/British
White – Irish
White – Other (please state)
Other ethnic group (please state)
Prefer not to say
Other, please specify:
Thank you for taking the time to respond to our consultation. Please return this form to:
Post:
FREEPOST Plus RTCT-JXLE-EET
South Gloucestershire Council
Strategic Transport Policy Team
MetroBus Extension Consultation
Civic Centre
High Street
Kingswood
BRISTOL
BS15 9TR
Or if completing electronically by email uploading at