Equal opportunities Form - Executive Director

Equal Opportunities Form

THIS INFORMATION IS CONFIDENTIAL.

As part of our agreement with our funders, we are required to collect this information from all participants.

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* 1. Name

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* 2. Age

0-19

20-34

35-49

50-64

65+

Prefer not to say

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* 3. What best describes your gender identity

Female

Male

Non-binary

Prefer not to say

Prefer to self describe:

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* 4. What is your ethnic origin?

White - British

White - Irish

White - Gypsy or Irish Traveler

White – Any other white background

Mixed – White & Black African

Mixed – White & Black Caribbean

Mixed – White & Asian

Mixed – Any other mixed background

Asian or Asian British – Bangladeshi

Asian or Asian British – Indian

Asian or Asian British – Pakistani

Asian or Asian British – Chinese

Asian or Asian British – Any other Asian background

Black or Black British – African

Black or Black British – Caribbean

Black or Black British – Any other Black background

Arab

Any other ethnic group

Not Known

Prefer not to say

Other (please specify)

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* 5. Nationaity.
If not from the UK, please tell us which country you are from.

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* 6. Disability.
Do you consider yourself to have a disability and / or impairment

I identify as a deaf or disabled person, or have a long term health condition

I identify as deaf but not disabled

Non disabled

Prefer no to say

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* 7. Sexual Orienatation

Heterosexual/ Straight

Bisexual

Gay Woman/ Lesbian

Gay man

Prefer not to say

Other (please specify)

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* 8. Eligible to work in the uk?

Yes

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* 9. Employment Status

Paid Employment – 30 or more hours per week

Paid Employment – 16 or more hours per week, but less than 30

Paid Employment – 8 or more hours per week, but less than 16

Self-Employed

Not looking or not available for work (e.g. Student, Carer, long-term sick or disabled)

Aged 14-19 and not in Education, Employment or Training

None of the above

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* 10. How did you find out about this opportunity?

Friend

Leaflet

Work

School/College

Poster

Website

Other (please specify)

All data collected in this survey will remain anonymous.

Question Title

* 1. Name

Question Title

* 2. Age

Question Title

* 3. What best describes your gender identity

Question Title

* 4. What is your ethnic origin?

Question Title

* 5. Nationaity. If not from the UK, please tell us which country you are from.

Question Title

* 6. Disability.Do you consider yourself to have a disability and / or impairment

Question Title

* 7. Sexual Orienatation

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* 8. Eligible to work in the uk?

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* 9. Employment Status

Question Title

* 10. How did you find out about this opportunity?

* 5. Nationaity.
If not from the UK, please tell us which country you are from.

* 6. Disability.
Do you consider yourself to have a disability and / or impairment