(please tick) Mixed White and Black – Caribbean What is your age: Mixed White and Asian – Chinese Under 18 Any other ethnic 18-25 background (please 26-35 specify) 36-45 Prefer not to say 46-55 56-65 What is your religion? 66-75 No religion 75+ Christian (including Do you consider yourself to have a Church of England, Catholic, Protestant, & all disability? other Christian denominations) Yes Buddhist No Hindu Jewish What is your sex/gender? Muslim Sikh Any other religion (please What is your ethnic group? specify) Prefer not to say White British – White Irish Which of the following options best – describes how you think of White Other Greek/Greek – yourself? Cypriot White Other Turkish – Heterosexual or Straight White Other Kurdish – Gay or Lesbian White Other - Gypsy/Roma Bisexual White Other Irish – Traveller Other (please specify) Black or Black British Prefer not to say – African Black or Black British – Caribbean Asian or Asian British - Indian Asian or Asian British – Pakistani Asian or Asian British – Bangladeshi Asian or Asian British – East African Asian Please return this form to Mixed White and Black – African
(please tick) What is your age: Under 18 18-25 26-35 36-45 46-55 56-65 66-75 75+ Do you consider yourself to have a disability? Yes No What is your sex/gender? What is your ethnic group? White – British White – Irish White Other – Greek/Greek Cypriot White Other – Turkish White Other – Kurdish White Other - Gypsy/Roma White Other – Irish Traveller Black or Black British – African Black or Black British – Caribbean Asian or Asian British - Indian Asian or Asian British – Pakistani Asian or Asian British – Bangladeshi Asian or Asian British – East African Asian Mixed – White and Black African Mixed – White and Black Caribbean Mixed – White and Asian Chinese Any other ethnic background (please specify) Prefer not to say What is your religion? No religion Christian (including Church of England, Catholic, Protestant, & all other Christian denominations) Buddhist Hindu Jewish Muslim Sikh Any other religion (please specify) Prefer not to say Which of the following options best describes how you think of yourself? Heterosexual or Straight Gay or Lesbian Bisexual Other (please specify) Prefer not to say Please return this form to
wrc_ambassadors_application_0.docx