Equal Opportunities Form - New Critical Voices Question Title * 1. What is your gender? Female Male Trans-female Trans-male Gender fluid Prefer not to say Other (please specify) Question Title * 2. Is this the same gender as you were assigned at birth? Yes No Question Title * 3. How would you describe yourself? (you can mark more than one option) Asian British Asian Bangladeshi Asian Indian Asian Pakistani Any other Asian background (please specify below) Black British Black African Black Caribbean Any other black background (please specify below) East Asian British East Asian Chinese East Asian Japanese East Asian Korean South East Asian Any other East Asian background (please specify below) Other ethnic group (please specify below) Mixed Heritage (please specify below) White & Asian White & East Asian White & Black British White & Black African White & Black Caribbean White British White English White Scottish White Welsh Northern Irish Irish Any other white background (please specify below) Prefer not to say Other (please specify) Question Title * 4. What is your sexual orientation? Bisexual Gay man Gay Woman/Lesbian Heterosexual/Straight Other Prefer not to say Question Title * 5. Please confirm which of the following age brackets you fit into 0 - 5 years 6 - 11 years 12 - 19 years 20 - 24 years 25 - 34 years 35 - 49 years 50 - 64 years 65 + years Prefer not to say Question Title * 6. What is your current relationship status? Married Civil Partnership Co-Habiting Single Divorced Widowed In a relationship Prefer not to say Other (please specify) Question Title * 7. What is your religion or belief system? Buddhist Christian Hindu Jew Muslim Sikh Other religion or belief (please specify below) No religion Atheist Agnostic Prefer not to say Other (please specify) Question Title * 8. Do you consider yourself to have a disability or long term health condition? Visual Impairment Hearing impairment/Deaf Physical disabilities Cognitive or learning disabilities Mental health condition Other long term/chronic condition Unknown Non disabled Prefer not to say Question Title * 9. If you answered yes to Question 8, do you have any access requirements? Done