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Username
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E-mail
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Password
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Confirm password
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Completing this section is optional. To make sure we are providing fair services to all of Southwark’s diverse communities, it is important that we ask you a few questions about yourself. You are under no obligation to provide the information requested, but it would help us greatly if you did. The information will be used to help us plan services that meet the needs of all users. Your responses will be kept confidential and any information published will be made anonymous. The information will be used in a statistical format only.
What is your age?
Please select
Under 16
16 - 17
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 - 74
75 - 84
85 - 94
95+
What do you consider to be your ethnic background?
Please select
White British
White Irish
White English
White Scottish
White Welsh
White Northern Irish
Other European
Other White (please specify if you wish)
Black British
Black Caribbean
Nigerian
Sierra Leonean
Somali
Other African
Other Black (please specify if you wish)
Asian British
Indian
Bengali
Chinese
Pakistani
Vietnamese
Filipino
Any other Asian (please specify if you wish)
Mixed white/Black Caribbean
Mixed White/Black African
Mixed White/Asian
Other Mixed background (please specify if you wish)
Latin American
Gypsy, Roma or Irish Traveller
Other ethnic background (please specify if you wish)
Please specify further if you wish:
Are you disabled?
Please select
Yes
No
Prefer not to say
Please specify further if you wish
What is your sex as recorded at birth?
Please select
Male
Female
Other (please specify if you wish)
Prefer not to say
Please specify further if you wish
Is your Gender Identity the same as the sex you were recorded at birth?
Please select
Yes
No
Prefer not to say
If no, how would you define your gender? Please specify if you wish
What is your sexual orientation?
Please select
Heterosexual/straight
Lesbian/Gay woman
Gay man
Bi-sexual
Other (please specify if you wish)
Prefer not to say
Please specify further if you wish
What is your religion or belief?
Please select
Christian
Sikh
Hindu
Muslim
Jewish
Buddhist
No religion
Other (please specify if you wish)
Please specify further if you wish
If you live or work in Southwark, in which community area do you live or work?
Please select
Bermondsey
Borough & Bankside
Camberwell
Dulwich
Elephant and Castle
Nunhead
Peckham
Rotherhithe
Walworth
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Homepage
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By registering, you confirm that you have read, understood and agree to our
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privacy policy
and
moderation policy
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