Equal Opportunities Monitoring Form

(Confidential – used for monitoring only)
We are committed to ensuring equality of opportunity in our work and aim to create an inclusive environment for all. To help us monitor our progress, please complete this form. The information provided is anonymous and will be kept strictly confidential. This form is optional, if you do not wish to complete, please select “prefer not to say” for each question.

Question Title

* 1. Age

Under 18

18-24

25-34

35-44

45-54

55-64

65+

Prefer not to say

Question Title

* 2. Gender

Woman

Man

Non-binary

Prefer not to say

Prefer to self describe:

Question Title

* 3. Is your gender identity the same as the sex you were assigned at birth?

Yes

Prefer not to say

Question Title

* 4. Sexual orientation

Heterosexual / Straight

Gay / Lesbian

Bisexual

Pansexual

Prefer not to say

Prefer to self-describe:

Question Title

* 5. Ethnicity

Question Title

* 6. Do you have a health condition or disability that limits your day-to-day activities?

Yes, I am greatly limited

Yes, I am somewhat limited

Yes, my limitations vary significantly day to day

No, I am not limited

Prefer not to disclose

Prefer to self-describe:

Question Title

* 7. Religion or belief

Question Title

* 8. Do you identify as being from a disadvantaged economic or social background?

Yes

Prefer not to say

Prefer to describe in your own words: