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Heterosexual Lesbian Gay Bisexual I do not wish to disclose this information * Please indicate you religion or belief Atheism Buddhism Christianity Islam Jainism Sikhism Judaism Hinduism Other I do not wish to disclose this information * Do you consider yourself to have a disability? Yes I do not wish to disclose this information No Please state the type of impairment which applies to you. People may experience more than one type of impairment, in which case you may indicate more than one. If none of the categories apply, please mark ‘other’. Physical Impairment Learning Disability/Difficulty Sensory Impairment Long-standing illness Mental Health Condition Other
GPGoverningBodyMemberApplicationForm.docx