qLegal Client Diversity form

Diversity Form

The data you provide will assist us in monitoring the effectiveness of our equality and diversity policies. It will also assist us in any funding applications we make in the future. The collection of this information complies with the Data Protection Act 1998. This information will only be used to prepare analyses and aggregated statistical reports and to develop policies.

Question Title

* 1. Which of the following applies to you?

Queen Mary Staff

Queen Mary Student

Member of the Public

Question Title

* 2. What is your employment status?

Employed

Self-employed

Unemployed

Disability Benefits

Full Time Student

Pensioner

Full Time Parent

Prefer not to say

Question Title

* 3. Gender?

Male

Female

Prefer not to say

Question Title

* 4. Is the gender indicated the same as your gender at birth?

Yes

Question Title

* 5. Age

Question Title

* 6. What is your Nationality?

Question Title

* 7. What is your Postcode?

Question Title

* 8. Sexual Orientation?

Heterosexual/Straight

Gay man

Lesbian/Gay Woman

Bisexual

Prefer not to say

Other (please specify)

Question Title

* 9. Do you consider yourself to have a disability?

Yes

Question Title

* 10. What is your ethnic group?

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race

Other (please specify)