Register your interest in the Connected Communities project
About You
Full Name
Postcode (First Part Only)
Are you a: (Tick all that apply)
Serving Personnel
Veteran
Family member of serving/veteran
Local resident
Community Organisation
Other
Other Self Description
Age (optional)
Please select...
5-7
8-11
12-14
15-18
19-25
26+
Gender (optional)
Please select...
Male
Female
Non-binary
Prefer not to say
Prefer to self-describe
Gender Self Description
Ethnicity (optional)
Please select...
White
Asian /Asian British
Black / African / Caribbean / Black British
Mixed / Multiple Ethnic groups
Other ethnic group
Prefer not to say
Engagement & Follow Up
Would you like to: (Tick all that apply)
Receive project updates
Take part in future consultation sessions
Join a community working group
Which locations are you interested in ? (Tick all that apply)
Portsmouth
Plymouth
Clyde
Future / New Locations
If you selected any of the above, please provide an email address we can contact you on:
Would you be happy for us to contact you about future opportunities related to Connected Communities?
Yes
No
Contact Information