WNC Solid Fuel Burning Survey

About you and your household

While this survey is anonymous, finding out a little more about you will help us to better understand who may or may not use solid fuel burning products.

Question Title

* 1. What is your Postcode?
If you do not have a fixed postcode, please give a nearby postcode.

Question Title

* 2. How many adults and children live in your home?
Air pollution effects people differently depending on their age. This will help us understand more about the potential impact of air pollution on your household.

	0	1	2	3	4	5	6	7	8	9
Adults aged 18 - 64	Adults aged 18 - 64 0	Adults aged 18 - 64 1	Adults aged 18 - 64 2	Adults aged 18 - 64 3	Adults aged 18 - 64 4	Adults aged 18 - 64 5	Adults aged 18 - 64 6	Adults aged 18 - 64 7	Adults aged 18 - 64 8	Adults aged 18 - 64 9
Adults aged 65 and over	Adults aged 65 and over 0	Adults aged 65 and over 1	Adults aged 65 and over 2	Adults aged 65 and over 3	Adults aged 65 and over 4	Adults aged 65 and over 5	Adults aged 65 and over 6	Adults aged 65 and over 7	Adults aged 65 and over 8	Adults aged 65 and over 9
Children aged 4 - 17	Children aged 4 - 17 0	Children aged 4 - 17 1	Children aged 4 - 17 2	Children aged 4 - 17 3	Children aged 4 - 17 4	Children aged 4 - 17 5	Children aged 4 - 17 6	Children aged 4 - 17 7	Children aged 4 - 17 8	Children aged 4 - 17 9
Children aged 0 - 3	Children aged 0 - 3 0	Children aged 0 - 3 1	Children aged 0 - 3 2	Children aged 0 - 3 3	Children aged 0 - 3 4	Children aged 0 - 3 5	Children aged 0 - 3 6	Children aged 0 - 3 7	Children aged 0 - 3 8	Children aged 0 - 3 9

Question Title

* 3. What type of home do you live in?

Flat or apartment (purpose built)

Flat or apartment (converted)

Terraced house

Semi-detached house

Detached house

Bungalow

Static or Park home

Mobile caravan

Canal boat

Other (please specify)

WNC Solid Fuel Burning Survey

About you and your household

Question Title

* 1. What is your Postcode? If you do not have a fixed postcode, please give a nearby postcode.

Question Title

* 2. How many adults and children live in your home?Air pollution effects people differently depending on their age. This will help us understand more about the potential impact of air pollution on your household.

Question Title

* 3. What type of home do you live in?

* 1. What is your Postcode?
If you do not have a fixed postcode, please give a nearby postcode.

* 2. How many adults and children live in your home?
Air pollution effects people differently depending on their age. This will help us understand more about the potential impact of air pollution on your household.