Equality Monitoring questionnaire - Anonymous collection
1.
What age are you?
16-24
25-34
35-44
45-54
55-64
65+
Prefer not to say
2.
Please tick the box which best describes your belief or religion from the list below
Buddhism
Catholic
Christian
Hinduism
Islam
Judaism
Protestant
Sikhism
No specific belief (for example atheism or agnosticism)
Other belief (for example humanism)
Prefer not to say
3.
Are you a person living with a disability?
Yes
No
if yes please tick the box which category you would use to from the following list:
Learning disabilities
Mental health issue (for example bi-polar, depression)
Neuro-divergent condition (for example Autistic spectrum, Dyslexia, Dyspraxia)
Physical impairment (for example wheelchair user, cerebral palsy)
Sensory impairment (hearing impairment, visual impairment)
Other
Prefer not to say
4.
Ethnicity - Please tick the box that best describes your particular group
African, African Scottish, African British including Caribbean
Other African background
Asian, Scottish Asian or British Asian including Indian, Bangladeshi, Pakistani, Chinese
Any other Asian background
Scottish
English
Irish
Welsh
Gypsy/Traveller
Roma
White European
Any other White background
Arab, Arab Scottish or Arab British
Other group - Please specify your ethnic group
Prefer not to say
5.
What is your sex?
Male
Female
Intersex
Prefer not to say