Equal Opportunities Monitoring Form

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We will use this data to inform our statistics and reporting on the representation of the categories
of individual as shown below. This information will be detached from any other information you
provide and filed anonymously. This information will not be shared with third parties.

What is your age? *

0-15

16-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75+

Prefer not to say

What is your sex? *

Female

Intersex

Male

Prefer not to say

Is your gender identity the same as the sex you were assigned at birth?
*

Yes

Prefer not to say

How would you describe your gender identity?

Man

Non-binary

Woman

Not applicable

Prefer not to say

Other:

With which ethnicity do you identify?

Arab

Bangladeshi

Chinese

Indian

Pakistani

Black African

Black Caribbean

Latin American

Asian & White

Black African & White

Black Caribbean & White

Gypsy, Roma or Irish Traveller

White British

White Irish

Prefer not to say

Not known

Other:

Do you identify as a D/deaf and/or D/disabled person, or have a long term health condition?
*

Yes

Prefer not to say

Do you identify as neurodivergent? Being Neurodivergent could include Dyslexia, ADHD etc.
*

Yes

Prefer not to say

What best describes your current or most recent occupation?

Clerical and intermediate occupations such as: secretary, personal assistant, call centre agent, clerical worker, nursery nurse.

Full-time education such as: studying for a degree or apprenticeship

Long term unemployed (claimed Jobseeker’s Allowance or earlier unemployment benefit for more than a year).

Modern professional & traditional professional occupations such as: teacher, nurse, physiotherapist, social worker, musician, police officer (sergeant or above), software designer, accountant, solicitor, medical practitioner, scientist, civil / mechanical engineer.

Retired

Routine, semi-routine manual and service occupations such as: postal worker, machine operative, security guard, caretaker, farm worker, catering assistant, sales assistant, HGV driver, cleaner, porter, packer, labourer, waiter/waitress, bar staff.

Senior, middle or junior managers or administrators such as: finance manager, chief executive, large business owner, office manager, retail manager, bank manager, restaurant manager, warehouse manager.

Small business owners who employed less than 25 people such as: corner shop owners, small plumbing companies, retail shop owner, single restaurant or cafe owner, taxi owner, garage owner.

Technical and craft occupations such as: motor mechanic, plumber, printer, electrician, gardener, train driver.

Not applicable (eg not currently working and not claiming benefits related to unemployment)

Prefer not to say

Not known

Other:

If you would like to expand on the above, please tell us what your current or most recent occupation is in your own words
*

How would you describe your sexual orientation?

Bisexual

Gay Man

Gay Woman / Lesbian

Heterosexual / Straight

Queer

Prefer not to say

Not known

Other:

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