Equal opportunities Form Trustee

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. Age

0-19

20-34

35-49

50-64

65+

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* 2. What best describes your gender identity

Female

Male

Prefer not to say

Prefer to self describe:

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* 3. What is your ethnic origin?

White - British

White - Irish

White – Other

Mixed – White & Black African

Mixed – White & Black Caribbean

Mixed – White & Asian

Mixed – Other

Asian or Asian British – Bangladeshi

Asian or Asian British – Indian

Asian or Asian British – Pakistani

Asian or Asian British – Other

Black or Black British – African

Black or Black British – Caribbean

Black or Black British – Other

Chinese

Not Known

Prefer not to say

Other (please specify)

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

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* 5. Disability.
Do you consider yourself to have a disability?

Yes

Prefer no to say

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* 6. Religion / Faith

Atheist

Bahai

Buddhist

Christian

Hindu

Jain

Jewish

Muslim

Sikh

Bahai

Interfaith

No religion

Prefer not to say

Other (please specify)

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* 7. Sexual Orienatation

Heterosexual

Bisexual

Gay/ Lesbian

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)

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* 1. Age

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* 2. What best describes your gender identity

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* 3. What is your ethnic origin?

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

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* 5. Disability.Do you consider yourself to have a disability?

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* 6. Religion / Faith

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* 7. Sexual Orienatation

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* 8. Eligible to work in the uk?

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* 9. Employment Status

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

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* 11. Name

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

* 5. Disability.
Do you consider yourself to have a disability?