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Section 2 of 3: About the area

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Section 3 of 3: Personal Details

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Q7: What do you think are the biggest issues facing people in the area? (Tick as many boxes as you like)
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Q9: Would you like to be involved in creating change in the area?
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Q6: What groups would you prioritise for changes/improvements to the area? (Tick as many boxes as you like)
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Section 2 of 3: About the area

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Section 2 of 3: About the area

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What is your age?
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What is your gender?
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Which best describes your connection to the area?
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What is your ethnic group?
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Do you consider yourself to have a long-term condition or disability?
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If you’d like us to stay in touch with news and ways to get involved, please let us have your contact details. We will not use your personal details for any other reason.

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Enter your phone number Enter a valid number like +1555-123-4567
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We will use it to shape the future!


The information you provide will be treated confidentially and reported anonymously. It will only be used for this consultation, equality monitoring and engagement analysis in accordance with UK GDPR and our privacy policies.

If you have any questions about our use of cookies or this policy, click here or email: hello@webprideinplace.co.uk. West Earlham Pride in Place is committed to handling your personal data in accordance with applicable UK data protection law.


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Section 3 of 3: Personal Details

This information helps us to know the range of people we have reached and who we’ve missed, but you do not have to fill it in.


1 - 2 - 3 - 4 - 5 - 6 - 7 - 8

Section 3 of 3: Personal Details

This information helps us to know the range of people we have reached and who we’ve missed, but you do not have to fill it in.


1 - 2 - 3 - 4 - 5 - 6 - 7 - 8

This information helps us to know the range of people we have reached and who we’ve missed, but you do not have to fill it in.


1 - 2 - 3 - 4 - 5 - 6 - 7 - 8

Section 3 of 3: Personal Details

Section 3 of 3: Personal Details

This information helps us to know the range of people we have reached and who we’ve missed, but you do not have to fill it in.


1 - 2 - 3 - 4 - 5 - 6 - 7 - 8

This information helps us to know the range of people we have reached and who we’ve missed, but you do not have to fill it in.


1 - 2 - 3 - 4 - 5 - 6 - 7 - 8

Section 3 of 3: Personal Details

This information helps us to know the range of people we have reached and who we’ve missed, but you do not have to fill it in.


1 - 2 - 3 - 4 - 5 - 6 - 7 - 8

Section 3 of 3: Personal Details

This information helps us to know the range of people we have reached and who we’ve missed, but you do not have to fill it in.


1 - 2 - 3 - 4 - 5 - 6 - 7 - 8

Section 3 of 3: Personal Details

This is required

The information you provide in this survey will be treated confidentially and reported anonymously.

It will only be used for this consultation, equality monitoring and engagement analysis in accordance with UK GDPR and our privacy policies.

Section 1 of 3: About you
Question: 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 - 11

Q1: In which area do you live? (Please only tick one)
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How to apply...

There are two different ways to apply:

Below you can complete a short Expression of Interest form , or submit a short video (up to 3 minutes) telling us about yourself. If you need support, whether that’s help with completing forms, translation of information into a different language, or accessibility, we will provide it. Closing date for applications is midday 4th June.



Request materials in a format that suits you:

We want to make applying as easy and inclusive as possible so please email us if you have any particular needs that we can help with.

Expression of Interest Form:

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Submit a short video:

This form is to be completed by people submitting Video Applications Only.

Submit Video

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