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SMART Equal Opportunities Monitoring Form
This form helps SMART to ensure that our opportunities are accessible to everyone, regardless of background.
The form should be completed by the applicant
(not the applicant's parent/carer/referee).
The information you provide will stay confidential, and be stored securely. It will only be used for monitoring purposes and will not be disclosed to any third party except where we are required to by law; where you have provided your explicit consent for us to pass data to a named third party (for example, Suffolk Youth Music); or a third party is purely processing data on our behalf.
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* Indicates required question
What are you applying for?
*
SMART Grant for Individual
SMART Scholarship
What best describes your gender?
*
Female (including trans women)
Male (including trans men)
Non-binary
Prefer not to say
Is your gender identity the same as the sex you were assigned at birth?
*
Yes
No
Prefer not to say
What is your sexual orientation?
*
Bisexual
Gay man
Gay woman / Lesbian
Heterosexual / Straight
Queer (other than above)
Prefer not to say
Not known
What is your age?
*
Your answer
Which of the following best represents your ethnic origin? Tick all that apply.
*
English/Welsh/Scottish/Northern Irish/British
Irish
Gypsy or Irish Traveller
Any other White/White British background, please describe in 'other'
White and Black Caribbean
White and Asian
Any other Mixed/Multiple ethnic background, please describe in 'other'
Indian
Pakistani
Bangladeshi
Chinese
Any other Asian/Asian British background
African
Caribbean
Any other Black/Black British background
Arab
Any other ethnic group
Prefer not to say
Not known
Other:
Required
Do you consider yourself to have a disability, physical or mental health condition? (The Equality Act states a disability or mental impairment which has a substantial and long-term adverse effect on your ability to carry about normal day-to-day activities.)
*
Identify as a disabled or deaf person or have a long-term health condition
Non-disabled
Prefer not to say
Not known
What is your religion or belief?
*
No religion or belief
Buddhist
Christian
Hindu
Jewish
Muslim
Sikh
Prefer not to say
Not known
Other:
Please select one option which best describes the sort of work your primary household earner undertook when you were 14 years old. (For those under 14, please select the option that best describes the sort of work your primary household earner current undertakes.)
*
Modern professional occupations, such as: teacher, nurse, physiotherapist, social worker, musician, police officer (sergeant or above).
Clerical and intermediate occupations, such as: secretary, personal assistant, clerical worker, call centre agent, nursery nurse.
Senior managers / administrators (usually responsible for planning, organising, coordinating and finance) such as: finance manager, chief executive.
Technical and craft occupations, such as: motor mechanic, plumber, printer, electrician, gardener, train driver.
Semi-routine manual and service occupations, such as: postal worker, machine operative, security guard, caretaker, farm worker, catering assistant.
Routine manual and service occupations, such as: HGV driver, cleaner, porter, packer, labourer, waiter/waitress, bar staff.
Middle or junior manager, such as: officer manager, retail manager, bank manager, restaurant manager, warehouse manager.
Traditional professional occupations, such as: accountant, solicitor, medical practitioner, scientist, civil/mechanical engineer.
Long term unemployed (claimed Jobseeker's Allowance or earlier unemployment benefit for more than a year).
Retired
This question does not apply to me
Not kown
Prefer not to say
Other:
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