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People's Voice - join the panel (this page)

People's Voice - join the panel

Please tell us what you think about our website, we welcome your feedback.

Customer notice

Due to essential maintenance some of our web services will be unavailable between these times 7pm Friday 25 May and 5pm Sunday 27 May 2012.

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Fields marked * are required.

Personal details

Firstname *

Surname *

House name or number *

Address 1 *

Address 2 *

Address 3 *

Town *

County *

Postcode *

Telephone *

Equality details

Please select your gender *

Male

Female

Please select your age range *

18-24

25-34

35-44

45-54

55-64

65-74

75 or over

Please select a group to which you belong *

White British

White Irish

White Other

White & Black Caribbean

White & Black African

White & Asian

Other Mixed

Black Caribbean

Other Black

Pakistani

Bangladeshi

Other Asian

Other

Please select your employment status *

Employed full time

Employed part time

Self Employed

Looking after home or family

Permanent Sick/Disabled

Retired

Full time Student

Part time Student

Unemployed

Please select your highest qualification *

A Level or equivalen

O Level/GCSE or equivalent

Degree or equivalent

No formal qualifications

Please select if you consider yourself to have any disability *

Yes, affecting hearing

Yes, other

Yes, affecting mobility

Yes, affecting vision

Please state if you or any of your household a member of the armed forces or MOD *

Yes

Please state how many children (under 18) there are living in the household

0 - 5 Years

6 - 10 Years

11 - 15 Years

16 - 18 Years

Please select your home status *

Own your own home (without a mortgage)

Own your own home (with a mortgage)

Shared ownership

Rent from the Council/Housing Association

Rent from a private landlord

Other

Does your household own a car *

Yes

If you are selected and form part of the Peoples Voice you will be given a unique reference number. You will then be able to take part in group discussions, telephone interviews etc.

Would you be willing to take part in any other forms of research? Please tick as many types of research approaches listed below that you would be willing to take part in.

I would be willing to take part in small group discussions about local community concerns *

Yes

I would be willing to take part in further research with face to face interviews with an authorised market researcher visiting me in my home. *

Yes

I would be willing to take part in a telephone survey *

Yes

I have read and accept the terms of the privacy statement *

Security question: Select '11' from the list
Why do I need to answer this?

Last updated: 13 June 2011

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