The Outside Lives Community Diversity and Interests Form

The Outside Lives Community Diversity and Interests Form
Purpose

To ensure that Outside Lives LTD are connecting communities and appealing to all, it is important for us to understand who we are reaching and exactly what people are passionate about. The purpose of this form is to find this out. The data collected will help us to focus our efforts on what you want from us, to see who we are not reaching and to help us effectively apply for funding. As a not for profit organisation, we rely on grants to help us deliver the activities you want to see.

We need all involved with Outside Lives to complete this form, so if there are members of your family or support circle who are not able to complete this form themselves, then please complete it on their behalf too.

Values

Outside Lives is based around the values of permaculture - caring for the people, the planet and the future. In line with our People Care value, we believe that there should be no discrimination because of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex or sexual orientation.To ensure that we are living this value, this form will be asking for personal information. Rest assured, this is anonymous so please answer as truthfully as you are able.
Outside Lives LTD Fair Data Processing Notice
Individual Information
MaleFemaleNon-BinaryPrefer not to answer
YesNoPrefer not to answer
Under 1616–2425–2930–3435–3940–4445–4950–5455–5960–6465+Prefer not to answer
MarriedCivil PartnershipDivorcedSingleCo-habitingSeparatedWidowedPrefer not to answerOther
What is your First Language? *
If you speak any other languages, please list here.
Which County Do You Live In?*
If Other, please specify:
I have a carI'm reliant on other people to bring meI use public transportI prefer to cycle or walk
Ethnicity

The following categories have been devised by the UK governments Census of population and are recommended by the Equality and Human Rights Commission. It is important to understand that these questions are not about nationality, place of birth or citizenship. Choose your answer from either the White, Mixed/Multiple Ethnic Groups, Asian/Asian British or Black/African/Caribbean/Black British.
EnglishWelshScottishNorthern IrishIrishGypsy or Irish TravellerPrefer not to answerOther
White and Black CaribbeanWhite and Black AfricanWhite and AsianPrefer not to answerOther
IndianPakistaniBangladeshiChineseArabPrefer not to answerOther
AfricanCaribbeanPrefer not to answerOther
My Nationality is:*
HeterosexualGay woman/lesbianGay manBisexualPrefer not to answerOther
No religion or beliefBuddhistChristianHinduJewishMuslimSikhPrefer not to answerOther
Two or more impairments and/or disabling medical conditionsSpecific learning disability (such as dyslexia or dyspraxia)General learning disability (such as Cerebral Palsy orDown’s Syndrome)Social/communication impairment such as Asperger’s or other autistic spectrum disorderLong-standing illness or health condition e.g.cancer, diabetes, chronic heart disease, epilepsy)Mental health condition such as depression, anxiety or bipolarPhysical impairment or mobility issues such as difficulty using arms or using a wheelchair or crutchesDeaf or serious hearing impairmentBlind or serious visual impairment uncorrected by glassesOther type of disability, impairment or medical conditionNo disabilityPrefer not to answer
Section 1 Complete- Just Section 2 To Go!
You and Us
Word of MouthSocial MediaPress (newspaper articles)Attended an EventReferred by an organisationOther
If referred by an organisation, please tell us who:
Events (Including Workshops and Activities)YouTube ChannelFacebookDedicated Volunteering Role (Community Gardening, Helping at Events)Dedicated Contractor Role (paid skills)
Foodies -This group focuses on using food to bring people together and it appeals to: anyone who likes food and company.Wild Tribe-All the activities of this group are based around wildlife and conservation and it appeals to: anyone who loves the outdoors and appreciates our wonderfulcountryside.Dig In - Activities are largely based around our community garden. (Produce grown is oftenused by our Foodie group).Take Note -This group are producing a series of musical classes and events, and it appeals to: any musical performers or people who would like to beAdventures -This team put the “active” in “activities” by exploring North Wales in many wayslike abseiling, climbing, bike rides, hiking, canoeing etc. (They are also brilliant at fundraising for Outside Lives).Green Room -This group are producing a series of theatre workshops and performances and it appeals to: budding thespians or people who love to try something new.Body and Soul -Provides activities centred around yoga, mindfulness,meditation and massage.No Plan-et B -Looking to raise awareness and providing practical advice and solutions tohelp reduce our carbon footprint and minimise our impact on the natural world.Art Box - All of these activities are based around arts and crafts appeals to: anyone who enjoys a creative process. No experience (or talent) is necessary!
Which of the above groups have you not heard about?
Have you visited Outside Lives Headquarters? *
If no, why not?
Have you been to an event we have hosted in your community? (eg Mold Rugby Club)*
Any costA cost higher than £5TransportPersonal TimeWeekday eventsWeekend eventsCaring ResponsibilitiesFacilities at venueDistance to eventOther
I'm a Facebook SurferI'm an Email checkerI'm an Instagram scrollerI'm a TweeterI love receiving postI like to read articles in the local pressI love chatting face to faceI'd like to see a dedicated Outside Lives website
I want to attend more events at HQI want to attend more Outside Lives events in my immediate communityI'd like to continue watching Outside Lives content on YouTubeI'd like to continue being involved in the Facebook groupsI would like to fundraise for Outside LivesI would like to volunteer for Outside Lives
What ideas do you have for future events?
Covid
I have suffered bereavement in lockdown(not necessarily COVID related)I have been suffering with my mental healthI'm a front line workerI have suffered with the stress of juggling work and homeI have been made redundantI have concerns about my employment statusI have missed schoolI have missed connecting with friends and familyI have enjoyed spending more time with my childrenI have been exploring the outdoorsI have harnessed my creativityI have developed new skills and interestsI've drunk a lot more wine and eaten too muchI have connected with my neighboursOther
If other, please tell us about it:
Now that lockdown is easing, how are you feeling about it?*
A great big THANK YOU from all of us here at Outside Lives! Your information will help us as a local business to develop and grow further. Go and grab a cuppa, you've earned it!
Should be Empty:

The Outside Lives Community Diversity and Interests Form

Individual Information

Ethnicity

Section 1 Complete- Just Section 2 To Go!

You and Us

Covid

A great big THANK YOU from all of us here at Outside Lives! Your information will help us as a local business to develop and grow further. Go and grab a cuppa, you've earned it!