EQUAL OPPORTUNITIES MONITORING FORM

Artes Mundi is committed to ensuring equality of opportunity and that job applicants are only considered on their ability to do the job. The form will be separated from your application on receipt and will play no part in the recruitment process. The information will be used for monitoring purposes only to ensure we are meeting our Equal Opportunities Policy and Strategic Equality Action Plan. It may be used in reporting to funders and other stakeholders.

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* 1. Where are you currently based?

East Midlands

East of England

South West

South East

London

West Midlands

Wales

North East

North West

Yorkshire and the Humber

Scotland

Northern Ireland

West Midlands

Prefer not to say

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* 2. How would you describe your gender?

Female

Male

Non-binary

Prefer not to say

Not known

Prefer to self-identify (please add in here)

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* 3. What is your age range?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

Prefer not to say

Not Known

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* 4. How would you describe your ethnicity?

Black or African American

Asian or Asian American

American or Alaska Native

Native Hawaiian or other Pacific Islander

Arab

Asian or British Asian – Indian

Asian or British Asian – Pakistani

Asian or British Asian – Bangladeshi

Asian or British Asian – Chinese

Asian or British Asian - Other Asian background

Black or Black British – African

Black or Black British – Caribbean

Black or Black British - Other

Black/African/Caribbean background

LatinX

Asian and White

Black African and White

Black Caribbean and White

White British

White Irish

White - Gypsy or Irish Traveller

Other White background

Other multiple ethnic background

Any other ethnic background

Not known

Prefer not to say

Prefer to self-identify (please add in here)

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* 5. Do you identify as disabled, or do you have a long-term health condition?

Yes

Yes - Blind/Visual Impairment

Yes - d/Deaf/Hearing Impairment

Yes - Learning difficulty

Yes - Mental health

Yes - Mobility

Yes - Speech impairment

Yes - Other disability

Prefer not to say

Prefer to self-describe (please add in here)

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* 6. Are you currently pregnant or on maternity leave

Yes

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* 7. How would you describe your sexual orientation?

Bi Man

Bi Woman

Gay Man

Gay Woman/Lesbian

Queer+

Heterosexual/Straight

Not Known

Prefer not to say

Prefer to self-identify (please add in here)

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* 8. Is your gender identity the same as the one assigned to you at birth?

Yes

Prefer not to say

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* 9. What is your religion/belief?

Buddhist

Christian

Hindu

Jewish

Muslim

Non-religious (Atheist, Humanist etc)

Sikh

Prefer not to say

Prefer to self-describe (please add in here)

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* 10. Do you have caring responsibilities?

Yes – primary carer for a child or children under the age of 18

Yes – primary carer for a child or children with disabilities

Yes – primary carer for an adult or adults with disabilities

Yes – primary carer for an older person or persons

Yes – secondary carer

Prefer not to say

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* 11. What is your highest qualification?

No formal qualifications

Secondary School level

ESOL/ Literacy qualifications

Further education (AS, A level, Diploma or NVQ level 2/3)

Higher education (Graduate)

Higher education (Postgraduate and Doctorate)

Vocational training

Prefer not to say

Other (please fill in the free text box below)

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* 12. What type of school did you go to?

A state run or funded school – non-selective

A state run or funded school – selective

Independent/fee paying school

Independent/fee paying school on a scholarship

Prefer not to say

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* 13. Were you eligible for Free School Meals at any time during your school years?

Yes

Not applicable (finished school before 1980 or went to school overseas)

Don't Know

Prefer not to say

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* 14. Please think about your parent(s) or other primary caregiver when you were around 14 years old. What kind of work did this parent/caregiver do?

Unemployed / never worked

Routine manual and service occupations e.g. van driver, cleaner, porter, waiter/waitress, bar staff

Semi-routine manual and service occupations e.g. postal worker, security guard, machine worker, receptionist, sales assistant

Technical and craft occupations e.g. fitter, plumber, printer, electrician

Clerical and intermediate occupations e.g. secretary, nursery nurse, office clerk, call centre agent

Middle or junior managers e.g. office manager, warehouse manager, restaurant manager

Modern professional occupations e.g. teacher, nurse, social worker, artist, musician, software designer

Traditional professional occupations e.g. accountant, solicitor, scientist, medical practitioner

Retired

Senior managers and administrators e.g. finance manager, chief executive, director

Prefer not to say

Prefer to self-describe (please add in here)

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* 15. Do you speak Welsh?

Yes fluent / first language

Some Basic Knowledge