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Powering Up Castle Vale Citizens Jury Selection Questionnaire

Thank you for your interest in the Citizens Jury.

The questions in this form will help us put together a Jury that reflects the people of Castle Vale and ensure we include a range of different views and experiences.

 

One of our team will be in touch by the end of February to let you know if you've been selected and what happens next.

Please confirm your date of birth
Day
Month
Year
Please confirm your gender
Female
Male
Trans/Non Binary
Other
Please select one of the following as your ethnicity
White
Mixed ethnic groups
Black Caribbean
Black African
Pakistani
Indian
Chinese
Bangladeshi
Other
How would you describe your economic status?
I am currently employed or self employed
I am not currently employed or self employed but I am looking for employment
I am not currently employed or self employed and I am not looking for employment
Please confirm how you would describe your current employment, the employment you are seeking or your last employment if you are not seeking employment
Caring, leisure, hospitality (restaurant, bar etc) and similar occupations
Administrative and secretarial
Sales and customer service
Factory or machine operations
Skill trades (plumbing, carpentry, building, maintenance etc)
Management or senior supervisory roles
Unskilled roles
Professional (lawyer, teacher, accountant etc)
Associate professional (paralegal, teaching assistant etc)
Please can you confirm which of the following best applies to you?
I consider myself to be disabled
I have a long term health condition that affects me on a day to day basis
I am neither disabled nor have a long term health condition that affects me on a day to day basis
Please can you confirm which of the following best applies to the home in which you live?
It is rented from the Council or a housing association
It is owned by me or someone in my household ("owner-occupied")
It is rented from a private landlord

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