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Source Equality and Diversity Monitoring Form
Many thanks for filling in this form. Your answers to the questions below will be anonymised and used to assess how we are working to achieve diversity and inclusion in our organisation. This information will not be connected to your application; it will be stored separately. All information provided will be treated as strictly confidential in line with the General Data Protection Regulation (GDPR) 2018. If you have any feedback or concerns about how we use your data, please contact Chloé via marketing@source.ie.
Once you have completed this form, please send your article to richard@source.ie with your name and your contact email. The application deadline is 5.30pm (GMT) on the 1st August 2023.
1.
Age
16 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 - 69
70 - 74
75 - 79
80 - 84
85+
Prefer not to say
2.
Gender Identity
Female
Male
Non-binary
Prefer not to say
Other/prefer to self-describe (please specify)
3.
Do you have caring responsibilities? If yes, please select all that apply
None
Primary carer of a child/children (under 18)
Primary carer of disabled child/children
Primary carer of disabled adult (18 and over)
Primary carer of older person/people (65 and over)
Secondary carer
Prefer not to say
4.
Do you consider yourself to be disabled?
Yes - Registered Disabled
Yes - Self-identified Disabled
No
Prefer not to say
5.
Do you identify as a D/deaf person?
Yes
No
Prefer not to say
6.
Which option best describes your ethnicity?
Mixed/Dual Heritage
Arab/Arab Irish/Arab British/Any other Arab background
Asian/Asian Irish/Asian British/Any other Asian background
Black/African/Caribbean/Black Irish/Black British/Any other Black background
Gypsy/Roma/Irish traveller
White/White Irish/White British/Any other White background
Prefer not to say
Other/prefer to self-describe (please specify)
7.
Which of the following best describes your sexuality?
Asexual
Bi/Bisexual
Gay man
Gay woman/Lesbian
Heterosexual/Straight
Prefer not to say
Other/prefer to self-describe (please specify)
8.
Do you identify as Trans/Transgender?
Yes
No
Prefer not to say
9.
What was the occupation of your main household earner when you were aged about 14?
Modern professional & traditional professional occupations
such as: teacher, nurse, physiotherapist, social worker, musician, police officer (sergeant or above), software designer, accountant, solicitor, medical practitioner, scientist, civil/mechanical engineer.
Senior, middle or junior managers or administrators
such as: finance manager, chief executive, large business owner, office manager, retail manager, bank manager, restaurant manager, warehouse manager.
Clerical and intermediate occupations
such as: secretary, personal assistant, call-centre agent, clerical worker, nursery nurse.
Technical and craft occupations
such as: motor mechanic, plumber, printer, electrician, gardener, train driver.
Routine, semi-routine manual, and service occupations
such as: postal worker, machine operative, security guard, caretaker, farm worker, catering assistant, sales assistant, HGV driver, cleaner, porter, packer, labourer, waiter/waitress, bar staff.
Long-term unemployed
: claimed Jobseeker's Allowance or earlier unemployment benefit for more than a year.
Small business owners who employed less than 25 people
such as: corner shop owners, small plumbing companies, retail shop owner, single restaurant or cafe owner, taxi owner, garage owner.
Other
such as: retired, this question does not apply to me, I don't know.
Prefer not to say