GEA Equality Monitoring Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This form is for Gender and Education Association Members and Executive Members

In order to better shape GEA's work as a international, intersectional feminist charity; to evaluate our activities, initiatives, and events; and to better understand and serve our members, we are asking questions related to: nationality, country of current residence, age, race/ethnicity, gender identity, disability, social class, religion/faith, sexual identity, and pronouns.

Categories have been drawn from standardised sources (such as HESA, Stonewall, and census questions) that we understand may not fully reflect the diversity of possible responses to each question. Please feel free to self-describe where the available categories do not fit with your identities.

All identity categories are optional. Should you wish not to disclose, please select ‘prefer not to say’.

Email *

Your Title

Mrs

Professor

Prefer not to say

Other:

Clear selection

First Name *

Last Name *

Your Pronouns

Nationality

Please list your nationality. If you hold dual nationality, please feel free to list both/all nationalities that apply.

Country of current residence

Please list the Country in which you currently reside.

Age

18-29

30-39

40-49

50-59

60-69

70-79

80-89

90+

Prefer not to say

Clear selection

Race/Ethnicity

Categories adapted from census questions. Feel free to select all that apply or feel free to self describe by selecting Other.

African, Caribbean, Black heritage

Arab or Middle Eastern heritage

Asian, East Asian, South Asian, Pacific Islander heritage

Gypsy, Roma, Traveller heritage

Latinx, Latina/o, Hispanic heritage

Native, Indigenous, First Nations heritage

White heritage

Prefer not to say

Other:

Disability

Question adapted from HESA. Feel free to select all that apply or to self describe by selecting Other.

Autistic spectrum disorder: A social/communication impairment such as Asperger's syndrome/other autistic spectrum disorder

Blind/partial sight: Blind or a serious visual impairment uncorrected by glasses

Deaf/partial hearing: Deaf or a serious hearing impairment

Long standing illness: A long-standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, or epilepsy

Mental health: A mental health condition, such as depression, schizophrenia or anxiety disorder

Learning difficulty: A specific learning difficulty such as dyslexia, dyspraxia or AD(H)D

Physical Impairment/Mobility: A physical impairment or mobility issues, such as difficulty using arms or using a wheelchair or crutches

No disability/ No Known Disability

Prefer not to say

Other:

Gender Identity

Question adapted from guidance published by Stonewall

Woman

Man

Non-binary/Genderqueer

Prefer not to say

Other:

Clear selection

Do you identify as Trans*?

Question adapted from guidance published by Stonewall. Feel free to self describe by selecting Other.

Yes

Prefer not to say

Other:

Clear selection

Social class

How would you describe the social class in which you grew up?

Religion/Faith

Do you practice and/or identify with a particular religion/faith? If yes, would you like to tell us which religion/faith?

Sexual Identity

Question adapted from guidance published by Stonewall

Ace/Asexual

Bi/Bisexual

Lesbian/Gay Woman

Gay Man

Pan/Pansexual

Queer

Questioning

Heterosexual/Straight

Prefer not to say

Other:

Clear selection

Privacy

The Gender and Education Association are committed to protecting the privacy and security of your personal information.The information from this form will only be shared confidentially with the GEA Executive Members in order to understand and better serve the GEA member community. Your individual responses will not be published. Collective data that does not identify individual members may be published by GEA.

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms