Ref no: Date rec’d: FOR OFFICIAL USE ONLY Draft Lodge Hill Development Brief consultation Response Form Please return this form to arrive no later than 5pm on Friday 14th October 2011 If necessary you may photocopy this form. Complete all sections clearly using black ink (or type). Please state relevant page and paragraph numbers and continue on a separate page if required. Return this form to the address given overleaf to arrive no later than 5 pm on Friday 14th October 2011. Personal Details: Contact Name: Organisation: Address: Post Code: E-mail: Tel: General Comments What is your overall opinion of the draft Development Brief? Strongly support Broadly support No opinion Broadly disagree Strongly disagree Do you have any comments to make on the overall draft Development Brief? Detailed Comments Which part of the document are you commenting on? (please give a page or paragraph number) Your comments: What changes (if any) to the document would you like to see to resolve these comments: Which part of the document are you commenting on? (please give a page or paragraph number) Your comments: What changes (if any) to the document would you like to see to resolve these comments: Which part of the document are you commenting on? (please give a page or paragraph number) Your comments: What changes (if any) to the document would you like to see to resolve these comments: Please continue on additional pages if necessary. Next Stage The Council will assess and summarise all the representations they receive on the draft Development Brief. These will be taken into consideration when the final version is produced, before it is adopted by the Council. A summary of the representations received will be published on the Council’s website at www.medway.gov.uk/lodgehill Signature: Date: ______________________________________ ____________________________ Please return this form to arrive no later than 5pm on Friday, 14th October 2011 to: By Post: Development Plans and Research, Medway Council, Gun Wharf, Dock Road, Chatham, Kent ME4 4TR By E-mail: [email protected] Medway Draft Lodge Hill Development Brief Consultation EQUALITY & DIVERSITY MONITORING FORM The information that you provide on this form will be used for monitoring and will not be used for any other purpose or stored electronically. Information will be used in aggregate form only and where there are less 3 people providing a response this will not be reported. AGE Please choose one option only. 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80 & over CARING RESPONSIBILITIES Do you have caring responsibilities (ie for children, parents or others)? Please choose one option only. 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