Customer Comments, Compliments and Complaints Privacy Statement Online Formrequired fields* Your Details Title* Select Mr Mrs Miss Ms Dr. Councillor First Name* Surname* Council Tax Reference (Glasgow City Council References only) Contact Number Email* Confirm Email* Your Address (Glasgow city council boundary search only)Flat NumberHouse Number*House NameStreet*City/Town*Postcode* Other Information about you Are you: MaleFemalePrefer not to say What age band do you fall into? Please select ... Under 15 15 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 and over Do you consider yourself to be a disabled person? YesNoPrefer not to say What is your ethnic origin? Please Select ... White Asian, Asian Scottish or Asian British Black, Black Scottish or Black British Other ethnic background Prefer not to say Your Comments Which venue/service are you telling us about Please use this space to explain the details such as dates, name of staff member, what happened and how we can put it right (2000 characters max)* Do you wish a response?* YesNo