Respondent Information Form - East Ayrshire Antisocial Behaviour Strategy 2013 - 2015

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East Ayrshire Antisocial Behaviour Strategy 2013 - 2015
Consultation
RESPONDENT INFORMATION FORM
Please Note. This form must be returned with your response to ensure that we handle your response
appropriately
1. Name/Organisation
Organisation Name
Title
Mr
Ms
Mrs
Miss
Dr
Please tick as appropriate
Surname
Forename
2. Postal Address
Postcode
Phone
Email
3. Permissions - I am responding as…
/
Individual
Group/Organisation
Please tick as appropriate
Do you agree to your response being made
The name and address of your organisation
(a)
(c)
available to the public (in East Ayrshire
will be made available to the public (in the
Council library and/or on the East Ayrshire
East Ayrshire Council library and/or on the
Council web site)?
East Ayrshire Council web site).
Please tick as appropriate
Yes
No
Where confidentiality is not requested, we will
Are you content for your response to be
(b)
make your responses available to the public
made available?
on the following basis
Please tick ONE of the following boxes
Please tick as appropriate
Yes
No
Yes, make my response, name and
address all available
or
Yes, make my response available,
but not my name and address
or
Yes, make my response and name
available, but not my address
We will share your response internally with other East Ayrshire Council policy teams who may be addressing
(d)
the issues you discuss. They may wish to contact you again in the future, but we require your permission to
do so. Are you content for East Ayrshire Council to contact you again in relation to this consultation
exercise?
Please tick as appropriate
Yes
No

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