KIT Theatre Equal Opportunity Monitoring Form

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* 1. Name

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* 2. Ethnicity

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* 3. Gender

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* 4. Do you identify as transgender?
For the purpose of this question “transgender” is defined as an individual who lives, or wants to live, full time in the gender opposite to that they were assigned at birth.

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* 5. Do you have a religion or belief?

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* 6. If YES please specify

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* 7. Sexual orientation

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* 8. Age

18-24

25-34

35-44

45-54

55+

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* 9. Do you consider yourself to have a disability according to the terms given in The Equality Act 2010?
"The Equality Act 2010 defines a person as disabled if they have a physical or mental impairment, which has a substantial and long term (i.e. has lasted or is expected to last 12 months) and has an adverse effect on the person’s ability to carry out normal day-to-day activities."

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* 10. If you have answered YES, please indicate the type of impairment which applies to you (by ticking below)

Deafness or partial loss of hearing

Blindness or partial loss of sight

Learning disability

Developmental disorder

Mental ill health

Long term illness or condition

Physical disability

Other (please specify)

KIT Theatre Equal Opportunity Monitoring Form

Question Title

* 1. Name

Question Title

* 2. Ethnicity

Question Title

* 3. Gender

Question Title

* 4. Do you identify as transgender?For the purpose of this question “transgender” is defined as an individual who lives, or wants to live, full time in the gender opposite to that they were assigned at birth.

Question Title

* 5. Do you have a religion or belief?

Question Title

* 6. If YES please specify

Question Title

* 7. Sexual orientation

Question Title

* 8. Age

Question Title

Question Title

* 10. If you have answered YES, please indicate the type of impairment which applies to you (by ticking below)

* 4. Do you identify as transgender?
For the purpose of this question “transgender” is defined as an individual who lives, or wants to live, full time in the gender opposite to that they were assigned at birth.