Equality & Monitoring Form

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In order to help us pursue our ambition of reaching all sections of the community, please complete the questions below. Any responses shall be used for survey information only and will not influence the assessment of your application. All information is kept securely and will remain confidential. This will only be shared selected with third parties for the purposes of equality and monitoring.

Completing these questions is voluntary. If you do not wish to complete the form please leave the answers blank and submit the application.

What gender do you identify as? *

Female

Male

Transgender

Non - binary

Prefer not to say

Other:

What age group do you belong to? *

18 - 25

26 - 35

36 - 45

46 - 55

56 - 65

65 +

Prefer not to say

Do you live in London? *

If you live in London, which borough of London do you live in?

Do you have any neurological or physical disabilities? *

If you have any neurological or physical disabilities please state them here

What ethnicity do you identify as? *

Asian or Asian British Bangladeshi

Asian or Asian British Chinese

Asian or Asian British Indian

Asian or Asian British Pakistani

Asian or Asian British Vietnamese

Asian: Any other Asian background (please state in next question)

Black or Black British African

Black or Black British Caribbean

Black: Any other Black background (please state in next question)

Mixed: White and Black African

Mixed: White and Black Caribbean

Mixed: White and Asian

Mixed: Any other Mixed background (please state in next question)

White: Welsh/English/Scottish/Northern Irish/British Irish

White: Gypsy or Irish Traveller

White: Any other White background (please state in next question)

Another ethic group not listed above (please state in next question)

Prefer not to say

If you identify as an ethnicity not listed in the previous question, please state it here.

If you wish to provide any further details please do so here.

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