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Equality Monitoring Form
It is important to us that we are able to measure our commitment to reaching people from all backgrounds, including those who may face barriers connected to their background, identity or current circumstances
1.
Role applying for:
2.
What is your age?
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 to 74
75 or older
3.
Do you consider yourself to be disabled?
Yes
No
Prefer not to say
4.
What is your ethnicity? (Please select all that apply.)
Asian or Asian British
Mixed or Dual Heritage
White
Black or Black British
Prefer not to answer
Chinese
Other (please specify)
5.
What is your sexual orientation?
Asexual
Bisexual
Gay
Heterosexual or straight
Lesbian
Pansexual
Queer
Prefer not to say
None of the above, please specify
6.
What is your current religion, if any?
Christian/Protestant/Methodist/Lutheran/Baptist
Catholic
Jewish
Muslim
Buddhist
Hindu
Atheist or agnostic
No religion
Other
Other (please specify)
7.
Gender