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Feedback / Complaints

Is this a Complaint or Feedback?

Feedback Complaint

Name:

House Name / Number:

Street Name:

Town / City:

Post Code:

Daytime Telephone Number:

Your Evening Telephone Number:

Email Address:

To Which Ethnic Group Do You Belong?

White	Black or Black British	Mixed
Bitish Irish Other White background	Caribbean African Other Black background	White and Black Caribbean White and Black African White and Asian Other mixed background

Chinese	Asian or Asian British
Other ethnic group Chinese	Indian Pakistani Bangladeshi Other Asian background

If Other, Please Give Details:

Please give details of your complaint

How would you like us to sort out this matter?