Wiltshire County Council are collecting this data to enable your details to be entered into the People's Voice Panel.
This is so that when you fill in a questionnaire we can look at the answers given by different groups of people.
The information will be anonymised (in other words your name and address will be removed) and used by the County Council, District Council's, Wiltshire police and Health Authority to make decisions about service planning and development.
By completing the form and selecting I agree, you are giving us consent to use the information you provide.
Wiltshire County Council holds and processes personal data in accordance with all current legislation relating to data protection and comply with the data protection act 1998.
Please select I agree to Continue or I disagree to Quit.