Questionnaire Text

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3. What is your date of birth?
Day _ _ Month _ _ Year _ _ _ _


10. What is your religion?

This question is voluntary.
[Check] one box only.

[] None
[] Christian (including Church of England, Catholic, Protestant and all other Christian denominations)
[] Buddhist
[] Hindu
[] Jewish
[] Muslim
[] Sikh
[] Any other religion, please write in ________