Details of person being referred

Oldham Council Working for a co-operative borough

Website maintenance - Tuesday 10 March

We are carrying out website maintenance on Tue 10 March. Some pages relating to councillors, meetings, agendas and minuets may be unavailable during this time, we apologise for any inconvenience.

This information will not be used to assess whether a referral should be adopted. Any personal data provided may support Equality Act obligations. Please only provide personal data if this information is already known from an official source or was provided by the person in question.

Is the individual... Required

A child / young person An adult

First name Required

Middle name(s)

Last name Required

Do you know their date of birth or approximate age? Required

Date of birth Approximate age

Gender Required

Male Female Trans Non-binary

Ethnicity Required

Asian or Asian British Black, Black British, Caribbean or African Mixed or multiple ethnic groups White Other ethnic group

Nationality

Immigration or asylum status

Immigration status? Refugee status? Asylum claimant? Please describe.

First language

Religion

Current address Required

Contact telephone number

Email address

Social media identifiers for example, usernames and platforms

Parent or guardian contact details

Any other details that may be relevant to the concern