Equalities monitoring How would you define your Female gender? Male (please specify) Don’t Know Is your current gender different Yes to the gender you were assigned No at birth? Don’t Know The 2010 Equality Act defines disability as physical or mental impairment which has a ‘a substantial and long term adverse [negative] effect on their ability to carry out normal day to day activities’ on the definition above, do Physical Deaf/ hearing impaired you consider yourself to have Learning Blind/ visually impaired any kind of disability? Mental Health Other (please specify): (please tick any that apply) Don’t Know How would you describe your ethnicity? White British White and Black Caribbean White Irish White and Black African White Gypsy or Irish Traveller and Asian Any other White background Any other mixed/ multiple background Asian British Black British Asian Indian Black African Asian Pakistani Black Caribbean Asian Bangladeshi Any other Black background Any other Asian background Other (please specify): Chinese Arab Don’t Know Do you have a faith/ religion? No religion Muslim Shinto Buddhist Sikh Christian Zoroastrian Hindu Other (please specify): Jewish Jain Don’t Know What is your sexual orientation? Heterosexual/ straight Gay woman/ Lesbian Bisexual Other (please specify): Don’t Know
Equalities monitoring How would you define your gender? Female Male (please specify) Don’t Know Is your current gender different to the gender you were assigned at birth? Yes No Don’t Know The 2010 Equality Act defines disability as ‘a physical or mental impairment which has a substantial and long term adverse [negative] effect on their ability to carry out normal day to day activities’ on the definition above, do you consider yourself to have any kind of disability? (please tick any that apply) Physical Learning Mental Health Deaf/ hearing impaired Blind/ visually impaired Other (please specify): Don’t Know How would you describe your ethnicity? White British White Irish White Gypsy or Irish Traveller Any other White background Asian British Asian Indian Asian Pakistani Asian Bangladeshi Any other Asian background Chinese Arab White and Black Caribbean White and Black African and Asian Any other mixed/ multiple background Black British Black African Black Caribbean Any other Black background Other (please specify): Don’t Know Do you have a faith/ religion? No religion Buddhist Christian Hindu Jewish Jain Muslim Shinto Sikh Zoroastrian Other (please specify): Don’t Know What is your sexual orientation? Heterosexual/ straight Gay woman/ Lesbian Bisexual Other (please specify): Don’t Know
Indigo-Freedom-Prog-information-form.docx