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J.5149-1020 Water

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What is your name, contact number and email address?
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Please tell us your age.
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Are you...
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What is your working status?  
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If applicable, what is your occupation and industry? 
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When was the last time you took part in Market Research and what was the topic of the research?

Please note we do keep a record and any applications from those who have recently taken part in research will be disregarded. 

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Who do you live with? If any children please include their ages...
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To ensure we recruit a representative mix, what is your ethnicity? 
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Do you or anyone in your household currently have any illnesses, impairments, disabilities, learning difficulties or mental health conditions that impact your day to day life? E.g. a physical disability, hearing loss, vision loss, arthritis, learning difficulties, anxiety etc.

If yes, Please can you tell me who has this condition, and how it affects your day to day life?

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Which of the following best describes who is responsible for paying your water bills?

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Which of the following best describes your water supply?