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Equality Monitoring Form
Student Minds is committed to meeting the aims and objectives set out in its Equal Opportunities Policy.
This includes following the 2010 Equality Act Legislation and monitoring the diversity of the people who work, volunteer and engage with us. This provides us with accurate data that can help us to improve equality and diversity across the organisation.
The information you provide will be confidential and will be stored securely and limited to relevant staff in the organisation.
By filling in this form you are helping to inform our actions to create inclusive environments.
Thank you!
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FIRST letter of the town/city you were born in
*
Your answer
LAST letter of the town/city you were born in
*
Your answer
What is your date of birth (DD/MM). E.g. 15th of January would be 1501.
*
Your answer
Gender
What is your gender identity?
*
Man
Woman
Non-binary
Prefer not to say
Other:
Does your gender identity align with the sex you were assigned at birth?
*
Yes
No
Prefer not to say
Other:
Sexual Orientation
How would you describe your sexual orientation?
*
Heterosexual/ straight
Homosexual/ gay/ lesbian
Bisexual/ pansexual
Queer
Asexual
Prefer not to say
Other:
Ethnicity
Which of the following best describes your ethnic origin?
*
Asian or Asian British
Black or Black British
White or Caucasian
Mixed
Prefer not to say
Other:
How would you define your ethnic origin?
Your answer
Religion or belief
How would you describe your religion or belief?
*
No religion or belief
Buddhist
Christian
Hindu
Jewish
Muslim
Sikh
Prefer not to say
Other:
Age
What is your age?
*
16-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65+
Prefer not to say
Disability and health
Do you identify as having a physical, sensory or cognitive disability? Or as having a long-term physical health condition?
*
Yes
No
Unsure
Prefer not to say
Do you have personal experience of mental health problems?
*
Yes
No
Unsure
Prefer not to say
If you feel you are experiencing mental health difficulties, how long have you been experiencing these?
N/A
Less than 6 months
Less than 1 year
More than 1 year
Prefer not to say
Clear selection
How would you define these difficulties? Please tick all that apply.
Depression
Anxiety
Psychosis
Eating difficulties
Personality disorder
Bipolar
OCD
Prefer not to say
N/A
Other:
Have you used mental health services?
Yes
No
Unsure
Prefer not to say
Clear selection
Socio-economic Status
What type of school did you mainly attend between the ages of 11 and 16?
*
State-run or state-funded school - selective on academic, faith or other grounds
State-run or state-funded school - non-selective
Independent or fee-paying school - bursary
Independent or fee-paying school - no bursary
Attended school outside the UK
Don’t know
Prefer not to say
Other:
What is the highest level of qualifications achieved by either of your parent(s) or guardian(s) by the time you were 18?
*
At least one has a degree level qualification
Qualifications below degree level
No formal qualifications
Don’t know
Prefer not to say
Other:
If you finished school after 1980, were you eligible for Free School Meals at any point during your school years?
*
Yes
No
N/A (finished school before 1980 or went to school overseas)
Don’t know
Prefer not to say
Marital Status and Caring Responsibilities
Are you?
*
Single
Married/ In a civil partnership
Separated
Widowed
Divorced/ Dissolved
With a partner
Prefer not to say
Other:
Do you have caring responsibilities?
*
None
Carer of a child/children (under 18)
Carer of a disabled/ill child/children (under 18)
Carer of a disabled/ill/elderly adult (18 and over)
Prefer not to say
Other:
Required
Student/ Recent Graduate Status
The following questions are only for current students, sabbatical officers and recent graduates (graduated within the last 3 years).
Are you currently a student or recent graduate?
*
I'm currently studying at university
I've graduated in the last 3 years
I'm a sabbatical officer
I'm on a leave of absence
I suspended my studies within the last year
Prefer not to say
No - None of the above apply to me
Other:
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