About You

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About You

These questions help us get a picture of who is applying for the community pot. All information collected anonymously and answering the questions is voluntary. Data gathered will be held by Bricks and may be shared with our funders.

What is your age?

What are the first 4 letters of your postcode?

How do you describe your ethnicity? (please circle)

Bangladeshi (Asian/Asian British)

Indian

Pakistani

Chinese

Any other Asian background

Asian and white

Black African and white

Black Caribbean and White

Any other mixed background

African (Black/Black British)

Caribbean (Black/Black British)

Any other Black background

White - English/N.Irish/Welsh/Scottish/British

White - Irish

White - Gypsy or Irish Traveller

Any other white background

Arab

Prefer not to say

My ethnicity is not listed above

I would prefer to self-describe (please do so using the box below)

Clear selection

If you would prefer to self-describe please do so here

How do you describe your gender?

Female

Prefer not to say

Non-Binary

Male

Prefer to self-describe (please do so using the box below)

Clear selection

If you would prefer to self-describe please do so here

Do you identify as trans?

Yes

Prefer not to say

Clear selection

How would you describe your sexuality?

If you would prefer to self-describe please do so here

Does the Social Model of Disability definition of being disabled apply to you?

The model says that people are disabled by barriers in society, not by their impairment or difference. Barriers can be physical, like buildings not having accessible toilets. Or they can be caused by people's attitudes to difference, like assuming disabled people can't do certain things.

Yes

Prefer not to say

Clear selection

Thanks for taking the time to complete this form. Any questions, please email georgia@bricksbristol.org

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