Surrey Heath Community Panel

1 Start 2 Your Preferences 3 Equal Opportunities 4 Complete


Become a member of the Community Panel by completing this form.

You can also state which consultation subject(s) you would prefer to participate in and how you would like to complete the consultation i.e. a posted hard copy, email or via an online form through the website (if available).

Equality Monitoring There are questions included in the membership form to aid our monitoring of equal opportunities. The Council wishes to make sure that it delivers quality services to the whole community, whatever their race, gender, age, disability, sexual orientation, gender re-assignment, religion or faith. To help us do this, and for that reason only, please answer these questions, although it will not affect your membership if you choose not to supply this information

Contact Details The Council is particularly interested in obtaining panel members' email addresses so that we can send as many surveys as possible via email.

All information that you provide will be treated in confidence and in accordance with the Data Protection Act 1998.

Note: Existing Community Panel members can use this form to supply any change of contact details or to update the consultation subject(s) they wish to participate in.


Your Details

Your Address