WCF:- Equality and Diversity Monitoring Form

Introduction

This is an optional form. All responses will be made anonymous.

In accordance with good practice and governance, the Worshipful Company of Farriers has a policy to collect data about the cultural background or diversity of those entering its examinations. This information can then be used to address any issues that relate to equality or diversity that arise from the examinations or in the delivery of services and the development of policies by the Company.

To assist the Company in discharging this duty, it would be greatly appreciated if you could complete this form alongside your examination application. The data collected will be treated in the strictest confidence in accordance with the provisions of the Data Protection Act 1998 and the various codes of practice issued by the Commission for Equality and Human Rights. It will only be accessed by authorised individuals at the Company and will not be disclosed to any other bodies or individuals. Statistics derived from this data will be used for monitoring purposes, may be published and may be passed to other bodies.

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* 1. Which exam will you be entering and when will it take place?

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* 2. What is your age?

0-18 years

19-24 years

25-34 years

35-44 years

45-54 years

55-64 years

65+ years

Prefer Not to Say

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* 3. What is your gender?

Female

Male

Prefer Not to Say

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* 4. Which of the following options best describes your sexual orientation?

Heterosexual or straight

Bisexual

Gay man

Gay woman or lesbian

Prefer Not to Say

Other

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* 5. What is your ethnicity?
Choose one section from A to E, then tick the appropriate box to indicate your ethnic group.

Section A: White

British, English, Northern Irish, Scottish or Welsh

Irish

Gypsy or Irish traveller

Any other white background, please specify

Section B: Mixed or multiple ethnic groups

White and Black Caribbean

White and Black African

White and Asian

Any other mixed or multiple ethnic background, please specify

Section C: Asian or Asian British

Indian

Pakistani

Bangladeshi

Chinese

Any other Asian background, please specify

Section D: Black, African, Caribbean or black British

Caribbean

African

Any other black British, African or Caribbean background, please specify

Section E: Other ethnic group

Arab

Any other ethnic group, please specify

Section F. Prefer not to say

None of the above, please specify...

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* 6. Do you have a disability, long-term illness or health condition?
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 at least 12 months) and adverse effect on the person’s ability to carry out normal day-to-day activities.

Yes

Prefer Not to Say

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* 7. Please place an X in the relevant box or boxes if any of the below apply to you.

Blind or sight loss

Deaf or hearing loss

Mobility – e.g. difficulty walking short distances or climbing stairs

Manual dexterity

Learning disability, where a person learns in a different way – e.g. dyslexia

Mental illness – e.g. schizophrenia, depression

Speech impairment

Cognitive disability – e.g. brain injury, autism, attention deficit hyperactivity disorder or Asperger’s syndrome

Other impairment – e.g. epilepsy, cardiovascular conditions, asthma, cancer, facial disfigurement, sickle cell anaemia, or progressive condition such as motor neurone disease.

Prefer not to say

Other (please specify)

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* 8. Are your day-to-day activities limited because of a health problem or disability
which has lasted, or is expected to last, at least 12 months?

Yes, limited a lot

Yes, limited a little

Prefer Not to Say

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* 9. What is your religion?

Christian

Jewish

Muslim

Buddhist

Hindu

No religion

Sikh

Prefer Not to Say

Any other religion, write in

WCF:- Equality and Diversity Monitoring Form

Introduction

Question Title

* 1. Which exam will you be entering and when will it take place?

Question Title

* 2. What is your age?

Question Title

* 3. What is your gender?

Question Title

* 4. Which of the following options best describes your sexual orientation?

Question Title

* 5. What is your ethnicity?Choose one section from A to E, then tick the appropriate box to indicate your ethnic group.

Question Title

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* 7. Please place an X in the relevant box or boxes if any of the below apply to you.

Question Title

* 8. Are your day-to-day activities limited because of a health problem or disabilitywhich has lasted, or is expected to last, at least 12 months?

Question Title

* 9. What is your religion?

* 5. What is your ethnicity?
Choose one section from A to E, then tick the appropriate box to indicate your ethnic group.

* 8. Are your day-to-day activities limited because of a health problem or disability
which has lasted, or is expected to last, at least 12 months?