Chester Students' Union Diversity Monitoring Form

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* 1. What role are you applying for?

Student Trustee May/June 2020

Democracy & Insight Co-ordinator June 2020

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* 2. Which of the following best describes your gender identity?

Man

Woman

Prefer not to say

In another way (Please describe [optional]

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* 3. Does the gender you live in match the gender you were assigned at birth?

Yes

Prefer not to say

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* 4. Age band

Under 18

18–29

30–39

40–49

50–59

60–65

Over 65

Prefer not to say

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* 5. How do you define your sexual orientation?

Heterosexual/Straight

Gay/Lesbian

Bisexual/Bi

Queer

Prefer not to say

In another way (please describe [optional])

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* 6. Do you consider yourself to have a specific learning disability, other disability, impairment, long-term illness or health condition?

Yes

Don’t Know

Prefer not to say

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* 7. Please describe your disability, impairment or long-term health condition. Please select all that apply.

Physical impairment such as using a wheelchair to get around and/or mobility difficulties

Blind or partially sighted

Deaf or hard of hearing

Mental health difficulties e.g. depression, schizophrenia

Learning difficulty where a person learns in a different way e.g. dyslexia, dyspraxia

Profound and/or multiple learning difficulties

Autistic Spectrum Disorder

An unseen disability or health condition e.g. diabetes, epilepsy, asthma, HIV

A disability not listed above (please describe)

Prefer not to say

No known disability, impairment or long-term health condition

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* 8. What is your Ethnicity?

Asian/Asian British- Bangladeshi

Asian/Asian British- Chinese

Asian/Asian British- Indian

Asian/Asian British- Pakistani

Black/ African/ Caribbean/ Black British - African

Black/ African/ Caribbean/ Black British- Caribbean

Mixed/multiple ethnic groups - Asian and White

Mixed/multiple ethnic groups - Black African and White

Mixed/multiple ethnic groups - Black Caribbean and White

Other ethnic group - Arab

White - British

White - English

White - Gypsy or Irish Traveller

White - Irish

White - Northern Ireland

White - Scottish

Any other ethnic background or group, please describe

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* 9. What is your Religion, Faith and/or Belief?

Buddhist

Christian (including Catholic, Church of England, Church of Scotland, Protestant and all other Christian denominations)

Hindu

Jewish

Muslim

Sikh

Spiritual

Agnostic

Atheist

Any other religion or belief (Please specify)

None

Prefer not to say

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* 10. How did you initally hear about the role you have applied for?

Word of mouth

Social media

CharityJobs

SU Careers

Indeed

Other (please specify)