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Full Name
*
Address (Including Postcode)
*
Where do you reside in?
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Northern Ireland
Republic of Ireland
Email Address or Phone Number
*
Which group or organisation did you hear about this project from?
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Leafair Community Association
EVOLVE NI
Éalú
Ulidia
Other
What best describes your gender identity?
*
— Select Choice —
Male
Female
Non-Binary
I prefer not to say
What is your age?
*
Online Registrations are for participants over 18 only
What is your ethnic group?
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— Select Choice —
White
Black / African / African American
Indian
Chinese
Asian
Other
What is your religious belief (if any)
*
— Select Choice —
Christian
Buddhist
Muslim
Hindu
Prefer not to say
Other
Which community do you identify with or were you brought up in?
*
I am a member of the Catholic Nationalist Republican Community
I am a member of the Protestant Unionist Loyalist Community
I am not a member of either Protestant or Catholic Communities
(if group? Address
Do you have a disability?
*
Yes
No
I prefer not to say
GDPR Agreement
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We are collecting this data to support the development of our FORWARD project. By completing this form, you consent to us collecting, storing, and using your personal information for this purpose. Your information will only be accessed by authorised staff working on the FORWARD project, including authorised staff employed by partner organisations where access is necessary to deliver the project.
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