Skip to content
Equalities Survey for Housing Applicants
Equalities Data Collection
We collect equality information to help us to plan and deliver effective services and to meet our legal and regulatory obligations. You can find out more here.
1.
Please select your age from the bands below:
16–24
25–34
35–44
45–54
55–65
65+
Prefer not to say
2.
Which best describes your belief or religion from the list below?
Buddhism
Christianity: Catholic
Christianity: Protestant
Christianity: Other
Hinduism
Islam
Judaism
Sikhism
No specific belief in religion (for example, atheism or agnosticism)
Prefer not to say
Other religion or belief (please specify what this is)
3.
Are you a disabled person?
Yes
No
4.
If you answered yes to Q3 please tick what category/categories you would use from the following list:
Autoimmune (for example multiple sclerosis, HIV, Crohn's/ulcerative colitis)
Learning difficulties (for example Down's Syndrome)
Mental health issues (for example depression, bi-polar)
Neuro-divergent condition (for example autistic spectrum, dyslexia, dyspraxia)
Physical impairment (for example wheelchair user, cerebral palsy)
Sensory impairment (hearing impairment)
Sensory impairment (visual impairment)
Prefer not to say
Other: if none of the categories above apply to you please specify the nature of your impairment.
5.
Which best describes your ethnic group?
African, African Scottish or African British
Other African background (please specify)
Bangladeshi, Bangladeshi Scottish or Bangladeshi British
Indian, Indian Scottish or Indian British
Pakistani, Pakistani Scottish or Pakistani British
Chinese, Chinese Scottish or Chinese British
Other Asian background (please specify below)
Caribbean, Caribbean Scottish or Caribbean British
Black, Black Scottish or Black British
Other Caribbean or Black background (please specify below)
Mixed or multiple ethnic group (please specify below)
Polish
Gypsy Traveller
Roma
White Scottish
White Irish
White English
White Welsh
White Other British
Other group (please specify your ethnic group below)
Prefer not to say
If you answered other, please specify here:
6.
Are you pregnant?
Yes
No
Prefer not to say
7.
Have you taken maternity or paternity leave in the past year?
Yes
No
Prefer not to say
8.
What is your sex?
Female
Male
Intersex
Prefer not to say
9.
Do you consider yourself to be a trans person?
Yes
No
Prefer not to say
10.
What is your sexual orientation?
Bisexual
Gay man
Heterosexual/straight
Lesbian/gay woman
Prefer not to say
Other (please specify)
