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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.

(Please select a maximum of 2 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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