<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"><html><head><meta name="GENERATOR" content="snap10 - pda3 questionnaire export"><meta http-equiv="Content-Type" content="text/html; charset=utf-8"><title>Consultation for Group changes</title><link type='text/css' charset='utf-8' rel='stylesheet' href='http://www.snapsurveys.com/swh/k/127849693952/genesis_consultation.css'><script language='javascript' type='text/javascript'>document.write("<style type='text/css'>form{display:none;}</style>");</script></head><body  onload="oL()"><script language='javascript' type='text/javascript'>document.write("<p id='snapIntro'>Please wait while the survey loads...</p>");</script><form action="siam/surveylanding/interviewer.asp" method="post" id="SnapForm"><input type="image" id="submit" src="images/1x1.gif" style="width:0%;height:0%;"><input type="hidden" id="SnapSession" name="SnapSession" value="746D7079756371676B313238333436323634302E3336"><input type="hidden" id="SurveyKey" name="SurveyKey" value="127849693952">
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<input type="hidden" id="PAGE" name="PAGE" value="1"><table summary="margins" width="100%"><tr><td colspan='3' style='height:3.0em;'></td></tr><tr><td style='width:3.0em;'>&nbsp;</td><td><table class="V2_classT" style="width:100%;" summary="Question" id="V2"><tr><td class="question_1" style="width:100%;"><h1 class="question_2"><img src="http://www.snapsurveys.com/swh/k/127849693952/genesis_housing_group_rgb_lores.jpg" alt="genesis housing group_rgb_lores" width='340' height='121' ></h1></td></tr></table><table style="width:100%;" summary="Spacer" id="V49_SPACER"><tr><td style="height:18px;"></td></tr></table><table class="V49_classT" style="width:100%;" summary="Question" id="V49"><tr><td class="question_3" style="width:100%;"><h1 class="question_4">Resident Consultation</h1></td></tr></table><table style="width:100%;" summary="Spacer" id="V3_SPACER"><tr><td style="height:18px;"></td></tr></table><table class="V3_classT" style="width:100%;" summary="Question" id="V3"><tr><td class="question_3" style="width:100%;"><h2 class="question_5">Feedback Form</h2></td></tr></table><table style="width:100%;" summary="Spacer" id="V4_SPACER"><tr><td style="height:18px;"></td></tr></table><table class="V4_classT" style="width:100%;" summary="Question" id="V4"><tr><td class="question_6" style="width:100%;">We hope you enjoyed reading our ‘We’re on a journey’ leaflet. For us to understand how you feel about what was said we’d be grateful if you could complete this short questionnaire. All answers will be kept confidential and you will automatically be entered into a prize draw to win £500 travel vouchers when you complete it.</td></tr></table><table style="width:100%;" summary="Spacer" id="V6_SPACER"><tr><td colspan="2" style="height:18px;"></td></tr></table><table class="V6_classT" style="width:100%;" summary="Question" id="V6"><tr><td class="name_1" rowspan="2" style="width:8%;height:100%;">&nbsp;</td><td class="question_7" style="width:92%;"><label for="V6_1">Name</label></td></tr><tr><td class="box_1" style="width:92%;height:2px;"><input type="text" size="52" maxlength="100" id="V6_1" style="width:100%;" name="V6"></td></tr></table><table style="width:100%;" summary="Spacer" id="V8_SPACER"><tr><td colspan="2" style="height:18px;"></td></tr></table><table class="V8_classT" style="width:100%;" summary="Question" id="V8"><tr><td class="name_1" rowspan="2" style="width:8%;height:100%;">&nbsp;</td><td class="question_7" style="width:92%;"><label for="V8_1">Address</label></td></tr><tr><td class="box_1" style="width:92%;height:2px;"><textarea rows="4" cols="52" id="V8_1" style="width:100%;" name="V8"></textarea></td></tr></table><table style="width:100%;" summary="Spacer" id="V9_SPACER"><tr><td colspan="2" style="height:18px;"></td></tr></table><table class="V9_classT" style="width:100%;" summary="Question" id="V9"><tr><td class="name_1" rowspan="2" style="width:8%;height:100%;">&nbsp;</td><td class="question_7" style="width:92%;"><label for="V9_1">Postcode</label></td></tr><tr><td class="box_1" style="width:92%;height:2px;"><input type="text" size="51" maxlength="100" id="V9_1" style="width:98%;" name="V9"></td></tr></table><table style="width:100%;" summary="Spacer" id="V10_SPACER"><tr><td colspan="2" style="height:18px;"></td></tr></table><table class="V10_classT" style="width:100%;" summary="Question" id="V10"><tr><td class="name_1" rowspan="2" style="width:8%;height:100%;">&nbsp;</td><td class="question_7" style="width:92%;"><label for="V10_1">Telephone/mobile no</label></td></tr><tr><td class="box_1" style="width:92%;height:2px;"><input type="text" size="52" maxlength="100" id="V10_1" style="width:100%;" name="V10"></td></tr></table><table style="width:100%;" summary="Spacer" id="V11_SPACER"><tr><td colspan="2" style="height:18px;"></td></tr></table><table class="V11_classT" style="width:100%;" summary="Question" id="V11"><tr><td class="name_1" rowspan="2" style="width:8%;height:100%;">&nbsp;</td><td class="question_7" style="width:92%;"><label for="V11_1">Email address</label></td></tr><tr><td class="box_1" style="width:92%;height:2px;"><input type="text" size="52" maxlength="100" id="V11_1" style="width:100%;" name="V11"></td></tr></table></td><td style='width:3.0em;'>&nbsp;</td></tr><tr><td colspan='3' style='height:3.0em;'></td></tr></table><table summary="buttons" width="100%"><tr><td  style='text-align:center;'>&nbsp; <img class='tools_1' src="http://www.snapsurveys.com/swh/k/127849693952/genesis_consultation_pbar01.gif" alt="Page 1/12"> &nbsp;</td></tr><tr><td  style='text-align:center;'>&nbsp; <input type="image" class='tools_2'src="http://www.snapsurveys.com/swh/k/127849693952/genesis_consultation_rset.gif" alt="Clear Answers from this Page" name='reset' value="Reset"> <input type="image" class='tools_2'src="http://www.snapsurveys.com/swh/k/127849693952/genesis_consultation_next.gif" alt="Next Page" name='next' value="Next &gt;&gt;"> &nbsp;</td></tr></table></form>
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