Under the Equality Act 2010 a disability is a physical or mental impairment; Yes No that has a substantial and long-term adverse effect on the ability to carry out normal day-to-day activities. Do you consider yourself to have a disability in accordance with the Equality Act? If you answered to the above question, please provide details on the ‘yes’ nature of your disability. What is your nationality? Was English your first language? Yes No If you answered to the above question, what was your first language? ‘no’ I would describe my ethnic origin as: Asian / Asian British Mixed / Multiple ethnic groups Undisclosed Bangladeshi Asian & White I do not wish to disclose my Chinese Black African & White ethnic origin Indian Black Caribbean & White White Pakistani Any other mixed / multiple Welsh / English / Scottish / Any other Asian background, ethnic background, please Northern Irish / British please describe: describe: Irish / African / Caribbean / Black Other Ethnic Group Gypsy or Irish Traveller British Arab Any other White background, African Any other ethnic group, please describe: Caribbean please describe: Any other Black / African / Caribbean background, please describe:
Under the Equality Act 2010 a disability is a physical or mental impairment; that has a substantial and long-term adverse effect on the ability to carry out normal day-to-day activities. Do you consider yourself to have a disability in accordance with the Equality Act? Yes No If you answered ‘yes’ to the above question, please provide details on the nature of your disability. What is your nationality? Was English your first language? Yes No If you answered ‘no’ to the above question, what was your first language? I would describe my ethnic origin as: Asian / Asian British Bangladeshi Chinese Indian Pakistani Any other Asian background, please describe: / African / Caribbean / Black British African Caribbean Any other Black / African / Caribbean background, please describe: Mixed / Multiple ethnic groups Asian & White Black African & White Black Caribbean & White Any other mixed / multiple ethnic background, please describe: Other Ethnic Group Arab Any other ethnic group, please describe: Undisclosed I do not wish to disclose my ethnic origin White Welsh / English / Scottish / Northern Irish / British Irish Gypsy or Irish Traveller Any other White background, please describe:
All%20Routes%20Personal%20Details%20and%20Payment%20Form%20May%202018.docx