TV referendum debate: Appeal for audience members

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Image caption,
The future of Scotland will be decided on 18 September

Would you like to take part in a debate about the Scottish independence referendum?

BBC Scotland is hosting a series of TV programmes at venues the length and breadth of the country and is appealing to members of the public to be part of the audience.

Voters in Scotland decide on their country's future when they go to the polls on Thursday, 18 September.

They will be asked the "yes/no" question: "Should Scotland be an independent country?"

The next TV debate will be in Aberdeen on 3 September, and finally Stirling on 14 September.

Audience members will need to be available between 16:30 and 20:30.

If you would like to be in the studio audience for any of these debates, fill in the form below to apply.

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. Which programme location are you applying for?

3. Which two issues would you most like to discuss?

4. How old are you?

5. What is your gender?

6. What is your occupation? If you are retired, what was your occupation before retiring?

7. Which ethnic group do you belong to?

Other (please specify)

8. Do you consider yourself to have any disabilities?

9. If disabled, do you require wheelchair access?

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

Other (please state)

11. If there was a Scottish Election tomorrow which political party would you be most likely to vote for?

Other (please state)

12. If there was an independence referendum tomorrow how would you vote?

13. How did you vote at the last General Election?

14. How did you vote at the last Scottish Election?

15. Are you a member of a political party?

16. If you are a member do you take an active role?

17. Are you active in any campaign groups?

18. Are you active in any referendum campaign groups?

Other (please specify)

19. We contact applicants individually - if any of your friends or family are applying with you please supply their names and telephone numbers so that we may contact them to discuss their applications.

* Required information