Industrial Biotechnology Champion for Scotland
Salutation
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Mrs
Ms
Mr
Mx
Dr
Professor
Name
First Name
Last Name
Preferred Pronoun
She/ her
He/ him
They/ Them
Current Job Title/ Position
Academic Institute
Academic Email
example@example.com
Why you would like to be an IB Champion (200 words max)
EDI Information - Gender
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Woman
Man
Non-binary
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Other
EDI Information - Age
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under 20
20-29
30-39
40-49
50-59
Over 60
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EDI Information - Ethnic Origin
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White British
White Scottish
White Irish
Other White background
Asian or Asian British - Indian
Asian or Asian British - Bangladeshi
Asian or Asian British - Pakistani
Chinese
Other Asian background
Black or Black British- African
Black or Black British - Caribbean
Other Black background
Mixed- White & Black African
Mixed – White & Asian
Mixed- White & Black Caribbean
Other mixed background
Not known
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Other not listed above
EDI information - Do you have a disability as defined by the Equality Act 2010?
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Yes
No
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