Asian Black Bangladeshi African □ □ Indian Caribbean □ □ Pakistani Any Other Black Background □ □ (specify if you wish) Any Asian Background □ (specify if you wish) ……………………………………………. Mixed Ethnic Background ……………………………………….. Chinese Asian and White □ Any Chinese Background Black African and White □ □ (specify if you wish) Black Caribbean and White □ Any Other Mixed Ethnic …………………………………………….. □ Background (specify if you wish) ………………………………………………… White background Any Other Ethnic Background □ (specify if you wish) Any Ethnic Background □ (specify if you wish) ……………………………………………… …………………………………………………
Asian Black □ Bangladeshi □ African □ Indian □ Caribbean □ Pakistani □ Any Other Black Background (specify if you wish) □ Any Asian Background (specify if you wish) ……………………………………………. ……………………………………….. Mixed Ethnic Background Chinese □ Asian and White □ Any Chinese Background □ Black African and White (specify if you wish) □ Black Caribbean and White …………………………………………….. □ Any Other Mixed Ethnic Background (specify if you wish) ………………………………………………… □ White background Any Other Ethnic Background (specify if you wish) □ Any Ethnic Background (specify if you wish) ……………………………………………… …………………………………………………
Nomination_for_a_National_Democracy_Week_Award__2_.docx