Apply here

Please complete this form to apply to become a member of the Transport, Climate and Place Disability Reference Group. If you require any assistance with applying, staff at the Council’s Community Hubs are available to help you. There are drop-in face-to-face sessions between 9.30am and 2.30pm Monday to Friday at our Community Hubs at Edmonton Green and Enfield Town Libraries. There is no need to book, just turn up.

Alternatively, you can apply by email to journeysandplaces@enfield.gov.uk or call us on 020 8132 0981.

What is your name?

* required

Maximum 255 characters

0/255

Please provide your phone number. This could be your personal assistants if preferred.

* required

Maximum 255 characters

0/255

What is your email address? This could be your personal assistant's email if preferred.

* required

What is your preferred contact method

Phone

* required

Live in Enfield

Study in Enfield

Work in Enfield

I have the following impairment(s):

* required

Physical (ambulant)

Physical (wheelchair user)

Sensory

Intellectual

Mental health

Other (please specify)

I am a personal assistant for a disabled person.

* required

Yes

How do you describe your gender?

* required

Man

Woman

Prefer not to say

In another way (specify below)

Please provide a brief statement of no more than 300 words on why you’re interested in volunteering as a member of the Disability Reference Group.

* required

Maximum 20,000 characters

0/20,000

10.

What age bracket do you fall into?

18 - 29

30 - 39

40 - 49

50 - 59

60 - 69

70 - 79

80 - 89

90+