Equal Opportunities Form

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Filling in this form is voluntary, but with your help, the information you provide us with will ensure that Andro and Eve continues to improve our services, supporting inclusion, equality and diversity.

Any information you provide will stay confidential, and be stored securely in line with GDPR laws.

All sections are optional. Feel free to provide as much information as you are willing.

Ethnicity

Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong.

What is your ethnicity? Please tick the appropriate box (only 1)

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

White | Irish

White | Gypsy or Irish traveller

White | Any other white background

Multiple Ethnic Group | Black Caribbean / White

Multiple Ethnic Group | Black African / White

Multiple Ethnic Group | Asian / White

Multiple Ethnic Group | Any other mixed or multiple ethnic background

Black or Black British Caribbean

Black or Black British African

Any other Black or Black British background

Asian or Asian British Indian

Asian or Asian British Pakistani

Asian or Asian British Chinese

Any other Asian or Asian British background

Arab

Other | Any other background

Prefer not to say

Other:

Gender

Please tick the box which you feel most represents you/you perceive you belong, or 'add other'

Female

Male

Non Binary

Genderfluid

Intersex

Agender

Other:

Is you gender different to that which was assigned at birth?

Yes

Prefer not to say

Clear selection

Sexual Orientation

Please select the option which you feel most represents you/you perceive you belong, or 'add other'

Heterosexual

Gay woman/lesbian

Gay man

Bisexual

Pansexual

Asexual

Queer

Prefer not to say

Other:

Clear selection

Age

Please select the appropriate option.

18-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65+

Prefer not to say

Clear selection

Do you consider yourself to have a disability or long term health condition?

Yes

Prefer not to say

Clear selection

Do you consider yourself to be neurodiverse?

Yes

Prefer not to say

Clear selection

Submit

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