About you

Amber Valley Borough Council is committed to ensuring our services are accessible and designed to meet the diverse needs of Amber Valley communities. By completing this form you are helping us make sure we are meeting this commitment. You do not have to give this information if you do not wish to.

However if you choose to complete this form your details will not be linked to any other forms you have submitted. Your information will be stored confidentially with our equalities team.

Tell us about you
Previous form details
Gender
Age
Ethnic group
Disabilities

A disabled person is someone who has a physical or mental impairment which has a substantial and long term adverse effect on their ability to carry out normal day to day activities.

Sexual Orientation
Religion

 

Need further help or information?

Contact the team directly on 01773 570222 or email enquiry@ambervalley.gov.uk