* 1. PERSONAL INFORMATION

* 2. Marital status

* 3. What is your age?

* 4. SEXUAL ORIENTATION

* 5. RELIGIOUS BELIEF
In the most recent UK Census the following religions were listed. Please place a tick in the box which most describes your religion, or add details of your religion if not listed below

* 6. ETHNIC ORIGIN
White

  British Irish White and Black Caribbean White and Black African White and Asian Indian Pakistani Bangladeshi Caribbean African Chinese
White
Mixed Asian
Black
Chinese
Other
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