Jog Derbyshire - Jog Leaders
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1. Information about you
33%
Name
Name
Jog Group
Jog Group
Telephone Number
Telephone Number
Email
Email
Postcode
Postcode
How old are you?
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
60+
How old are you?
Gender
Male
Female
Gender
Do you consider yourself to have a disability?
Yes
No
Do you consider yourself to have a disability?
Which district do you live in? (who you pay your Council Tax to)
Amber Valley
Bolsover
Chesterfield
Derbyshire Dales
Erewash
High Peak
North East Derbyshire
South Derbyshire
Derby City
Which district do you live in? (who you pay your Council Tax to)
Other (please specify)
How did you hear about Jog Derbyshire
Referral (from health service)
Active Derbyshire Website
Local Leisure Centre
Promotional Display (eg in library)
Word of mouth
Article in press
Other
How did you hear about Jog Derbyshire
Other (please specify)
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