Inclusion Form - Grants Officer

Revive MS Support Inclusion, Equalities, Diversity and Accessibility Monitoring Form 2023

As part of our commitment to becoming a fully inclusive organisation, we listen to and aim to engage with the broadest range of people. To achieve this, we are striving to understand more about who works with us and/or uses our services - we'll use this data to develop our recruitment and engagement strategy.

All information entered into this form is:
Confidential;
Anonymous; and
Will only ever be reported in summary form.

Question Title

* 1. How would you describe your ethnic origin?

Black African (Black / African / Caribbean / Black Scottish/British/English/Welsh or Northern Irish Heritage)

Black Scottish/British (Black / African / Caribbean / Black Scottish/British/English/Welsh or Northern Irish Heritage)

Black Caribbean (Black / African / Caribbean / Black Scottish/British/English/Welsh or Northern Irish Heritage)

Black African & White (Mixed Heritage)

Black Caribbean & White (Mixed Heritage)

Any Other Black Background

Bangladeshi (South Asian / South Asian Scottish/British/English/Welsh or Northern Irish)

Indian (South Asian / South Asian Scottish/British/English/Welsh or Northern Irish)

Pakistani (South Asian / South Asian Scottish/British/English/Welsh or Northern Irish)

Chinese (East Asian / East Asian Scottish/British/English/Welsh or Northern Irish)

Any Other South Asian Background

Any Other East Asian Background

South Asian & White (Mixed Heritage)

East Asian & White (Mixed Heritage)

Any other Mixed Heritage

Arab

Iranian

Iraqi

Kurdish

Turkish

Latina o/x

Irish

Gypsy or Traveller

Polish

White Scottish/British/English/Welsh/Northern Irish

White other. Please describe below:

My ethnicity is not included above. I would prefer to self describe below:

Prefer not to say

Describe or self describe as:

Question Title

* 2. How would you describe your gender?

Female

Male

Non-binary

My gender is not included above. I would prefer to self describe below:

Prefer not to say

Self describe as:

Question Title

* 3. How would you describe your sexual orientation?

Asexual

Bisexual

Gay

Heterosexual/Straight

Lesbian

Queer

Pansexual

My sexual orientation is not included above. I would prefer to self describe below:

Prefer not to say

Self describe as:

Question Title

* 4. Do you identify as trans?

Yes

Prefer not to say

Question Title

* 5. The following questions and how we are asking them is based on our research into best practice in gathering data about disability from other organisations in the UK.
Do you identify as a person who is disabled, d/Deaf, neurodivergent or has a long-term physical or mental health condition?

Yes

Prefer not to say

Question Title

* 6. If you have a disability, please select from the following?

Cognitive or learning disabilities

A long term or chronic condition

D/deaf

Physical disabilities

Visual impairment

A mental health condition

My disability is not included above. I would prefer to self describe below

Prefer not to say

Not applicable

Self describe as:

Question Title

* 7. What age are you?

16 - 24

25-34

35-44

45-54

55-64

65+

Prefer not to say

Question Title

* 8. We are interested in exploring socio-economic inclusion, the question below is the current best practice approach to capturing this information - if you have any feedback on this there is space at the end of the survey.

Please tell us about the occupation of your main household earner when you were aged 14. Please tick one box to show which best describes the sort of work your primary household earner undertook at this time.

Modern Professional Occupations (E.g. Teacher/lecturer, nurse, physiotherapist, social worker, welfare officer, actor, artist, musician, police officer (sergeant or above), software designer)

Clerical and Intermediate Occupations (E.g. secretary, personal assistant, clerical worker, office clerk, call centre agent, nursing auxiliary, nursery nurse)

Senior Managers and Administrators(Usually responsible for planning, organising and co-ordinating work for finance such as finance managers, chief executive etc)

Technical and Craft Occupations (E.g. motor mechanic, fitter, inspector, plumber, printer, tool maker, electrician, gardener, train driver)

Semi-Routine Manual and Service Occupations (E.g. postal worker, machine operative, security guard, caretaker, farm worker, catering assistant, receptionist, sales assistant)

Routine Manual and Service Occupations(E.g. HGV driver, van driver, cleaner, porter, packer, sewing machinist, messenger, labourer, waiter/waitress, bar staff)

Middle or Junior Managers (E.g. office manager, retail manager, bank manager, restaurant manager, warehouse manager, publican)

Traditional Professional Occupations (E.g. solicitor, accountant, medical practitioner, scientist, civil/mechanical engineer)

Short Term Unemployed (Claimed Universal Credit or earlier unemployment benefit for a year or less)

Long Term Unemployed (Claimed Universal Credit or earlier unemployment benefit for more than a year)

Retired

Not applicable

Don't know

Prefer not to say

The occupation is not included above. I would prefer to describe below:

Self describe as:

Inclusion Form - Grants Officer

Revive MS Support Inclusion, Equalities, Diversity and Accessibility Monitoring Form 2023

Question Title

* 1. How would you describe your ethnic origin?

Question Title

* 2. How would you describe your gender?

Question Title

* 3. How would you describe your sexual orientation?

Question Title

* 4. Do you identify as trans?

Question Title

* 5. The following questions and how we are asking them is based on our research into best practice in gathering data about disability from other organisations in the UK. Do you identify as a person who is disabled, d/Deaf, neurodivergent or has a long-term physical or mental health condition?

Question Title

* 6. If you have a disability, please select from the following?

Question Title

* 7. What age are you?

Question Title

Question Title

* 9. Do you have any feedback on this form?

* 5. The following questions and how we are asking them is based on our research into best practice in gathering data about disability from other organisations in the UK.
Do you identify as a person who is disabled, d/Deaf, neurodivergent or has a long-term physical or mental health condition?