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* 1. Please enter your full name:

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* 2. Please provide your job role/full title:

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* 3. Which Faculty / Professional Services department are you from?

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* 4. Which network role(s) would you like to nominate yourself for? 

Please read the Network Role Descriptors which have been sent to you via email, for full descriptions of each role - A copy can also be found here.

(Please select a maximum of 3 roles)

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* 5. Please provide a short statement (paragraph) outlining why you feel you would be suitable for the role(s):

(Please note: These comments may be used during the nomination and voting process) 

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* 6. If you have selected "Project Lead/Co-ordinator", please provide a short paragraph outlining the project(s) you would be most interest in championing:

(Top-tip: It may help to read through LJMU's four main EDI Priorities for 2020 - 2024 before answering)

Alternatively, please write not applicable (N/A)  in the box provided, if this question does not apply to you.

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* 7. Within each staff network, we would like to ensure their is a fair gender-balance of leading representatives, where possible.

Please could you indicate which sex/gender you identify as:

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* 8. Within each staff network, we would like to ensure their is a fair ethnicity-balance of leading representatives, where possible.

Please could you indicate which ethnicity/race you identify as:

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