Scotland politics

Audience plea for Scottish referendum debate programme

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

Would you like to be part of Newsnight Scotland's debate on the Independence Referendum and what it means for minority communities in Scotland?

Newsnight Scotland will be hosting a special debate on Monday 28 January. The discussion will look at how Scotland's ethnic and immigrant communities are engaging in the referendum debate, looking at their possible concerns and hopes.

Are you from an ethnic minority background or do you work with minority communities in Scotland? If so, and if you have views and questions about Scotland's future, we'd like to hear from you and invite you to apply to be a member of our audience.

The programme will be broadcast at 10:30pm on BBC Two Scotland on Monday 28 January.

If you are interested in joining the audience, 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