Luton Irish Forum EQUALITY MONITORING FORM We ask for this information to monitor the achievement of our Equal Opportunities policies. This information is kept confidential. Date Gender - Date of Birth - DD/MM/YYYY Are you male or female? Ethnic Origin - Please tick one box that describes your ethnic origin most closely. White Mixed Asian or Black or Chinese or Traveller/ Asian British Black British other ethnic Gypsy group Irish Carribean Indian Carribean Chinese Irish Traveller British African Pakistani African Other, Gypsy Please write Other Asian Bangladeshi Any other in: Roma White Black Other Other Asian Other background, Mixed background, background, Traveller Please write Please write background, Please write background, in: in: Please write in: Please write in: in: Sexuality - How would you define your sexuality? Lesbian Gay Bisexual Heterosexual Other Disability - Are you registered disabled or would you consider yourself as having a disability? Yes No If yes, please give details Source How did you hear about Luton Irish Forum? –
Luton Irish Forum EQUALITY MONITORING FORM We ask for this information to monitor the achievement of our Equal Opportunities policies. This information is kept confidential. Date Gender - Are you male or female? Date of Birth - DD/MM/YYYY Ethnic Origin - Please tick one box that describes your ethnic origin most closely. White Mixed Asian or Asian British Black or Black British Chinese or other ethnic group Traveller/ Gypsy Irish Carribean Indian Carribean Chinese Irish Traveller British African Pakistani African Other, Please write in: Gypsy Other White background, Please write in: Asian Bangladeshi Any other Black background, Please write in: Roma Other Mixed background, Please write in: Other Asian background, Please write in: Other Traveller background, Please write in: Sexuality - How would you define your sexuality? Lesbian Gay Bisexual Heterosexual Other Disability - Are you registered disabled or would you consider yourself as having a disability? Yes No If yes, please give details Source – How did you hear about Luton Irish Forum?
EqualityMonitoringForm-4.docx