Audience plea for Scottish referendum debate programme

Union flag and saltire The future of Scotland has been the focus of an ongoing debate

BBC Scotland is appealing for members of the public to join an audience for the latest in a series of debates on the future of Scotland.

We are particularly interested in 16 and 17-year-olds being part of the television special on Monday, 5 November - at Motherwell Concert Hall.

Audience members need to be available from 17:00 onwards.

Last week, the Scottish and UK governments signed a deal setting out terms for a Scottish independence referendum.

The agreement, struck in Edinburgh, paved the way for a vote in autumn 2014, with a single Yes/No question on Scotland leaving the UK.

When, where, time?

  • Monday, 5 November
  • Motherwell Concert Hall
  • From 17:00 onwards

It will also allow 16 and 17-year-olds to take part in the ballot.

If you are interested in joining the audience for the debate, fill in the form below.

Guidelines require the BBC to have a balanced audience for this event.

To help us do this, we will ask all members of the audience whether they are associated with a political party or if they already have a favoured view on whether Scotland should become independent or remain part of the UK.

1. Name and address

2. Your Contact Details

3. What is your occupation?

4. To help us ensure a broad range of views, we'd like to ask if you've decided how you might vote in next year's independence referendum.

5. If there were a General Election tomorrow, which political party would you be most likely to vote for?

Other (please state)

6. Are you a member of a political party?

If Yes which party

7. The audience for BBC Scotland Debates is totally proactive and we wish to ensure that the opportunity to put forward questions and take part in the debates is given to those people wishing to participate. Would you please confirm that you are keen to get involved and if selected will ask your question.

8. Briefly, what is your view of the monarchy?

9. What two questions would you like to ask?

10. Which of these groups do you consider yourself to belong to?

Other (please specify)

11. Of what nationality do you consider yourself?

Other (please specify)

12. Do you consider yourself to have any disabilities?

13. If you are disabled, do you require wheelchair access?

14. Have you been on a BBC Scotland TV or Radio Debate before?

15. How old are you?

16. The information you provide will be collected by the BBC. Are you happy for your email details to be retained so that we may contact you about appearing in the audience for other BBC programmes?

* Required information

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