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Participant Equalities Form
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What group or event are you attending today?
Your answer
Gender
Male
Female
Other
Prefer not to say
Clear selection
What is your age bracket?
0-10
11-15
16 - 24
25-49
50-64
65-74
75 -84
85+
Prefer not to say
Clear selection
Do you consider yourself to be Disabled?
Yes
No
Prefer not to say
Clear selection
If you consider yourself to be disabled, please tell us the type of disability you have.
Your answer
What is your sexual orientation?
Bisexual
Lesbian or Gay
Heterosexual
Other
Prefer not to say
Clear selection
Is your gender identity different to that assigned at birth?
Yes
No
Prefer not to say
Clear selection
Do you follow any of the below Faiths?
Buddhist
Christian
Hindu
Jewish
Muslim
Sikh
Pagan
None
Don't know / not sure
Other faith, religion or belief
Prefer not to say
Clear selection
Race and Identity
Asian / Asian British
Black / Black British /African / Caribbean
Mixed / Multi ethnic group
White - British
White - Irish
White - Other
Gypsy / Roma / Irish Traveller
Prefer not to say
Clear selection
Are you pregnant or have you given birth in the last 26 weeks?
Yes
No
Prefer not to say
Clear selection
Are you a refugee or asylum seeker?
Yes
No
Prefer not to say
Clear selection
Is your main residence within the boundary of the Lockleaze?
Yes
No
Not sure
Clear selection
Any comments you would like to make on our inclusivity are welcome...
Your answer
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