West Berkshire Council

Apply to Join the Community Panel

Share your opinion on issues of local importance

iCM Form
    1. Name
    2. Address Postcode
    3. Address Details
      1. Numbers, spaces, + , ( , and ) are all valid characters
    4. Are you? *
    5. What was your age on your last birthday?
    6. How many adults (18 or over) live in your household?
    7. How many children (0-17 years old) live in your household?
    8. In which of these ways does your household occupy your current accommodation? *
    9. Do you have any long-standing illness, disability or infirmity? ^^ *
    10. ^^(Long-standing means anything that has troubled you over a period of time or that is likely to affect you over a period of time).
    11. To which of these groups do you consider you belong?
    12. Please specify
    13. How did you find out about the panel?
    14. Character Counter
  1. Email Confirmation