1Page 1 2Page 2 3Summary Progress Before you begin Thank you for your interest in joining the Pride in Place Board. Please complete this form to express your interest. We ask for no more than 500 words in total. Your responses will help us understand your connection to the area, your motivation for joining, and the experience you can bring to the Board. Your details First name Last name Address Postcode Find Address Loading addresses... Select Address -- Please select -- Address line 1 Address line 2 (optional) City Postcode Clear postcode/address Use the Lookup Postcode button to find the address.If you cannot find the address, please enter it manually Email Telephone Your area Which Pride in Place area are you interested in joining? You need to have a close connection with the area by either being from, living or working in the area. You may select more than one area. Please ensure that if you select more than one area, your answers below cover all the areas. Select area(s) Everton East Fairfield West and Newsham Park Norris Green East Speke East Don't know What is your connection to the Pride in Place area? Please briefly describe your connection to the area. You could include information here that you are a local resident, member of a community or voluntary group or you have worked in the area for a significant time. Why are you interested in joining the Pride in Place Board? Skills and experience What experience would you bring to the Board? Please outline your relevant skills, experience or perspectives. Tell us about your skills and experience (optional) (select all that apply) Financial experience / qualifications Communications experience / qualifications including social media Media experience Social media skills Procurement experience Local knowledge of the area No information is required, please proceed to the next page. Equality and Diversity Information We would like the Board to be representative of the community so would appreciate you completing the following information. Your age range -- Please Select -- 19 or under 20-29 30-39 40-49 50-59 60-69 70+ Prefer not to say Do you have a disability, impairment or health condition which affects your day-to-day activities? Yes No Prefer not to say What is your ethnicity? (optional) This may be different from your nationality, place of birth or citizenship Asian Black, African, Caribbean or Black British Mixed or Multiple ethnic groups White Another ethnic group Prefer not to say Religion or belief -- Please Select -- No religion or belief Buddhist Christian Hindu Jewish Muslim Sikh Other Prefer not to say What is your sex? Male Female Non-binary Prefer not to say Is the gender you identify with the same as your sex recorded at birth? Yes No Prefer not to say What is your sexual orientation? -- Please Select -- Asexual Bisexual Gay Heterosexual Lesbian Pansexual Questioning Prefer to self-describe Prefer not to say Please specify No information is required, please proceed to the next page. Before you submit this form please review your answers below. If you need to change anything, use the 'previous' button on the bottom left to go back to a section. Then submit the form by selecting the 'Submit button' at the bottom of this page Loading form summary...