Launchpad: Monitoring Form

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For access support and alternative formats please call 0116 482 1394 or email info@serendipity-uk.com

This form should take less than 3 minutes to complete.
The form has the option to "prefer not to say" or the option to leave the question blank and is optional.

Monitoring information helps Serendipity to provide accurate data on who is engaging with us and our work and to ensure that we are providing equality of access for all, to see where gaps need to be addressed and to take positive action. Your personal information will be held confidentially in accordance with our privacy policy (available at www.serendipity-uk.com) and collated, anonymised data may be shared with our funders to contribute to wider surveys of the creative industries. For instance, ongoing Arts Council England's research to provide a benchmark from which to build in the future, better understand access to the arts and culture and what barriers there may be.

This information will only ever be used to support an open call or recruitment decision if we have stated this within an application process. It will never be used as part of selection criteria at shortlisting stage, but if specified, it will be used in the final selection stage to ensure there is diverse representation across our opportunities.

First Name

Last Name

Home Postcode

Date of Birth

YYYY

How would you describe your gender?

Male (including trans men)

Female (including trans women)

Non-binary

Prefer not to say

Self-describe (please tell us in the box below)

Clear selection

If you would like to self describe your gender, please do so here.

Is your gender identity different to the sex you were assumed to be at birth?

Yes

Prefer not to say

Clear selection

How would you describe your ethnicity?

How would you describe your sexual orientation?

Lesbian

Gay

Bisexual

Heterosexual

Queer

Prefer not to say

Self-describe (please tell us in the box below)

Clear selection

If you would like to self describe your sexual orientation, please do so here.

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

Yes

Prefer not to say

Clear selection

Do you consider yourself to be a primary carer?

Yes

Prefer not to say

Clear selection

Do you identify as having a lower socio-economic background?

Yes

Prefer not to say

Clear selection

Submit

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