A Better Connected Essex - Personal information - Essex County Council

Personal information

This section asks for information about you. Any personal information you provide is confidential and will be used solely for monitoring purposes.

What is your full name?

Name

What is your postcode?

Postcode (Required)

Which of the following reasons explain your interest in Essex? Please select all that apply.

(Required) Live in Essex Work in Essex Visit Essex Have family or friends in Essex Have a business or organisation which is based in Essex Have a business or organisation which operates in Essex Other

If you selected other, please specify

Which of the following areas do you live in?

Area

If you selected other, please specify

Are you responding on behalf of a business or organisation?

Yes No

If you are responding on behalf of a business or organisation, what is the name of that business or organisation?

What is your email address?

Email address