Thank you for your interest in joining Auckland City Council's community feedback panel, Listening Post. To become a member you must have an e-mail address and complete this form.

We ask for details that will help us understand the range of feedback we receive, correspond with you appropriately, and provide suitable access and meeting facilities should we meet.

Your details and feedback will be used for Auckland City Council consultation purposes only and will be held in the strictest confidence.


Title
Other (please specify)
First name
Family name
If you are representing an organisation on Listening Post, please tell us its name
Are you the person solely or jointly responsible for paying rates to Auckland City Council for a property you own?
Street address
Suburb
City
Country
Your e-mail address (please check carefully as this is how we will correspond with you)
We would like you to provide us with some optional personal information to help us understand the range of responses we receive from the Listening Post membership and ensure that we make your Listening Post participation as easy as possible.
Which gender are you?
What year were you born?
Please indicate which of the following best describes your work status
Other (please specify)
Which ethnic group(s) do you belong to?
Other (please specify)
Which language(s) are spoken in your home?
Other (please specify)
Which of the following best describes the type of household you live in?
If you have children living at home are they:
Including yourself, how many people usually live in the same household as you?
What is your household's (or apartment's) annual income?
To ensure we provide for members' needs at Listening Post consultation events, please indicate any facility (such as wheelchair access or a hearing loop) that needs to be available for you to take part.
What are your interests? Please tick all that apply.
Other (please specify)
Which areas of council are you interested in? Please tick all that apply.
Other (please specify)