Public Protection Service Equality Monitoring Form

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* 1. Please confirm which service area you have had contact with recently:

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* 2. Are you?

Female

Male

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* 3. Which best describes your ethnicity?

Any other background (please specify)

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* 4. Which best describes your age group?

16-18

19-25

26-29

30-39

40-49

50-59

60-64

65+

Prefer not to say

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* 5. Which best describes your religion or belief:

No religion or belief

Christian

Buddhist

Muslim

Hindu

Jewish

Sikh

Prefer not to say

Other (please specify)