And which group does your nominee identify with? Please tick one box Black Bangladeshi African □ □ Indian Caribbean □ □ Pakistani Any Other Black Background □ □ (specify if you wish) Any Other Asian Background □ (specify if you wish) ……………………………………………. Mixed Ethnic Background ……………………………………….. Chinese 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 ………………………………………………… White background Any Other Ethnic Background □ (Specify if you wish) Any Other Ethnic Background □ (Specify if you wish) ……………………………………………….. ……………………………………………………
And which group does your nominee identify with? Please tick one box Black □ Bangladeshi □ African □ Indian □ Caribbean □ Pakistani □ Any Other Black Background (specify if you wish) □ Any Other Asian Background (specify if you wish) ……………………………………………. ……………………………………….. Mixed Ethnic Background Chinese □ 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 ………………………………………………… □ White background Any Other Ethnic Background (Specify if you wish) □ Any Other Ethnic Background (Specify if you wish) ……………………………………………….. ……………………………………………………
Nomination_for_a_National_Democracy_Week_Award__2_.docx