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Comments about help needed
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Gender
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Male
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Date of Birth
Ethnic Origin
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Mixed-White & Black Caribbean
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Chinese
Other
Black or Black British-African
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Employment Status
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Unemployed less than 6 months
Unemployed 6 - 11 months
Unemployed 12 - 24 months
Unemployed 24 - 36 months
Unemployed 36 months +
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Residency Status
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Please select if one of the following applies to help us check we are reaching people who need help
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Ex-Offender
Homeless
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Mental Health Service User
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Generated: 18/08/2005 | Modified: 23/03/2011 by
Andrew Bothamley
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