Equality and Diversity Monitoring Form

NAME wants to meet the aims and commitments set out in its equality policy. This includes not discriminating under the law and building an accurate picture of the makeup of the workforce in encouraging equality and diversity.

The organisation needs your help and co-operation to enable it to do this, but filling in this form is voluntary. The information provided will be kept confidential and will be used for monitoring purposes.

If you have any questions about the form, please contact CONTACT.

Gender Male Female Intersex Non-binary Prefer not to say 

Is the gender you identify the same as your gender registered at birth?

Yes No Prefer not to say

Age  16-24      25-29      30-34        35-39      40-44      45-49        50-54          55-59      60-64     65+         Prefer not to say   

What is your ethnicity?

Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong. Please tick the appropriate box

 

Asian or Asian British

Indian         Pakistani        Bangladeshi       Chinese     Prefer not to say     

Any other Asian background, please write in:             

........................................