Age  16 24  25 34  35 44  45 54  55 64  64+ – – – – –  Prefer not to say Sexual Orientation  Bisexual  Gay Man  Gay  Heterosexual/Straight  Other  Prefer not to say Marriage and Civil Partnership  Single  Married  Civil Partnership  Separated  Divorced  Widowed  Prefer not to say Religious Belief  Buddhist  Jewish  Muslim  Christian  Hindu  Sikh  Other  Prefer not to say …………………………………….. Disability The Equality Act 2010 defines a disabled person as someone who has a physical or mental impairment which has a substantial and long-term adverse affect on their ability to carry out normal day-to-day activities. Do you consider yourself to be disabled?  Yes  No  Prefer not to say If Yes, please specific: Name: Signed: ………………………………………………….. …………………………………….. Date: Job Title: …………………………………………………… …………………………………..
Age  16 – 24  25 – 34  35 – 44  45 – 54  55 – 64  64+  Prefer not to say Sexual Orientation  Bisexual  Gay Man  Gay  Heterosexual/Straight  Other  Prefer not to say Marriage and Civil Partnership  Single  Married  Civil Partnership  Separated  Divorced  Widowed  Prefer not to say Religious Belief  Buddhist  Jewish  Muslim  Christian  Hindu  Sikh  Other ……………………………………..  Prefer not to say Disability The Equality Act 2010 defines a disabled person as someone who has a physical or mental impairment which has a substantial and long-term adverse affect on their ability to carry out normal day-to-day activities. Do you consider yourself to be disabled?  Yes  No  Prefer not to say If Yes, please specific: Name: ………………………………………………….. Signed: …………………………………….. Date: …………………………………………………… Job Title: …………………………………..
basketball-england-equal-opp-monitoring-form-new.docx