Norfolk FA Equality and Diversity Survey - Participants

Diversity Monitoring Form

Diversity monitoring is the process of gathering and analysing data on people's characteristics. The protected characteristics detailed in the Equality Act (2010) are age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation. This monitoring allows us to understand the makeup of the Norfolk footballing community that we serve. Participation is entirely optional and you are not obliged to self-declare your characteristics. However, by participating it provides us with a clear picture of the make-up of those involved with Norfolk Football and allows us to understand and address under-representation, should it exist. The data collected in this survey is confidential, anonymous and stored in line with GDPR.

By taking part in this survey you will be entered into a prize draw to win from a choice of either a £100 Amazon voucher or £100 Nike voucher, if you provide a valid email address and take the survey in the month of September 2019. Please note that your email address will be separated from your responses upon submission, and will not be used for marketing purposes or shared with any other parties.

Question Title

* 1. Please select the relevant category that matches your age.

Under 18

18-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85 and over

Prefer Not To Say

Question Title

* 2. Do you consider yourself to be a disabled person?

A disabled person is defined under the Equality Act 2010 as someone with a "physical or mental impairment which has a substantial and long term adverse effect on that person's ability to carry out normal day-to-day activities"

Yes

Prefer Not To Say

Question Title

* 3. If you consider yourself as having a disability and have answered yes to the previous question, how would you describe your impairment?

Hearing impairment (deaf or hard of hearing)

Visual impairment (blind or partially-sighted)

Physical impairment – ambulant (I do not use a wheelchair)

Physical impairment – wheelchair user

Learning impairment/disability (e.g. Downs Syndrome, etc)

Learning difficulty (e.g. movement coordination difficulty (Dyspraxia), dyslexia, etc.)

Long-term illness (e.g. cancer, HIV+ etc)

No disability - skip question

Other (please specify)

Question Title

* 4. Are you...?

Male

Female

Prefer Not To Say

Question Title

* 5. Do you identify, or have you ever identified as transgender?

Yes

Prefer Not To Say

Question Title

* 6. How would you describe your ethnicity?

Asian British

Bangladeshi

Black African

Black British

Black Caribbean

Chinese

Indian

Pakistani

White British

White Irish

White & Asian

White & Black African

White & Black Caribbean

Prefer Not To Say

Any other mixed/multiple ethnic background or white background...(Please Specify)

Question Title

* 7. How would you describe your sexual orientation?

Heterosexual/Straight

Bisexual

Gay Woman/Lesbian

Gay Man

Prefer Not To Say

Prefer to self-describe...

Question Title

* 8. How would you describe your religion or belief?

Atheist

Buddhist

Christian

Hindu

Jewish

Muslim

No religion

Sikh

Prefer Not To Say

Other (please specify)

Question Title

* 9. What is your role in Norfolk Football? Please select all that apply to you.

Player

Coach/Manager

Referee

Club Official/Volunteer

Prefer not to say

Other (please specify)

Question Title

* 1. Please select the relevant category that matches your age.

Question Title

* 2. Do you consider yourself to be a disabled person?A disabled person is defined under the Equality Act 2010 as someone with a "physical or mental impairment which has a substantial and long term adverse effect on that person's ability to carry out normal day-to-day activities"

Question Title

* 3. If you consider yourself as having a disability and have answered yes to the previous question, how would you describe your impairment?

Question Title

* 4. Are you...?

Question Title

* 5. Do you identify, or have you ever identified as transgender?

Question Title

* 6. How would you describe your ethnicity?

Question Title

* 7. How would you describe your sexual orientation?

Question Title

* 8. How would you describe your religion or belief?

Question Title

* 9. What is your role in Norfolk Football? Please select all that apply to you.

Question Title

* 10. Please provide your email address in the box below:

* 2. Do you consider yourself to be a disabled person?

A disabled person is defined under the Equality Act 2010 as someone with a "physical or mental impairment which has a substantial and long term adverse effect on that person's ability to carry out normal day-to-day activities"