Cumbria Constabulary Citizens Panel Membership


1. Title


2. Name


3. Address


4. Email Address


5. The personal data you provide on this membership form will be processed by Cumbria Constabulary in accordance with the EU General Data Protection Regulation and will only be used to contact you for purposes connected with membership of the Citizen’s Panel.

Your data will not be supplied to any other organisation, unless we are required to do so by law, and will be held for a period of 3 years. After 3 years you will be contacted again and asked if you consent for your details to continue to be held and processed in connection with your membership of the Panel.

At any time, you may withdraw your consent for the Constabulary to process your details in connection with your membership of the Panel.

Upon receipt of notification of your wishes, your details will be removed from the membership database and you will no longer receive correspondence about the Citizen’s Panel.

You may withdraw your consent by contacting the Data Protection Officer using the details provided below, providing your name, address and stating that you no longer wish to be a member of the Citizen’s Panel.

Data Protection Officer
People Department, Corporate Support
Cumbria Constabulary, Police HQ
Carleton Hall, Penrith
Cumbria, CA10 2AU

Further details about how Cumbria Constabulary process personal data can be found on our website at:

By ticking the box below, I confirm that I wish to become a member of the Cumbria Constabulary Citizen’s Panel.

I understand that Cumbria Constabulary will retain the personal details recorded on this form for the period of my membership of the Panel.

I understand that I may withdraw my consent for Cumbria Constabulary to hold these details at any time by contacting the Data Protection Officer using the details provided above.

I would like to become a member of Cumbria Constabulary’s Citizens Panel


6. Please indicate how you would prefer to receive a survey from the Constabulary


7. Please enter your gender


8. Date of birth


9. What is your ethnic group?


10. Please select your religion


11. Please enter your sexual orientation


12. Do you consider yourself to have a disability or substantial medical condition?


13. If yes, please tick those (if any) which apply from the categories listed below:


14. What is your current employment status? Please tick all that apply.


15. Tenure