Equal Opportunity Promotion and Documentation Form

1
Full Name
First Name
Last Name
2
Email Address
example@example.com
3
Gender: Please select the option that best describes your gender identity.
Intersex
Non-binary
Man
Woman
Prefer not to say
Other
4
Do you identify as Trans?
Yes
No
Prefer not to say
5
Age
0-19
20-34
35-49
50-64
65+
6
EthnicityWe understand that identity is more personal and complex than a single tickbox, so we are asking everyone to self-define. You can also choose to skip this section, if you prefer not to disclose this information.
7
Do you consider yourself to have a disability or long-term, chronic health condition/s?Do you consider yourself to have a disability or long-term, chronic health condition/s?
Yes
No
Prefer not to say
8
Do you identify as neurodiverse?Do you consider yourself to have a disability or long-term, chronic health condition/s?
Yes
No
Prefer not to say
9
Do you have any accessibility needs or accommodations?
Visual impairment
Hearing impairment
Mobility challenges
Cognitive or learning disabilities
Other
None
10
Is there anything you would like to add about your access needs?
11
Sexual Orientation
Bi/Bisexual
Gay Man
Gay Woman/Lesbian
Heterosexual/Straight
Queer
Prefer not to say
Other
12
Religion
Buddhist
Christian
Hindu
Jewish
Muslim
No Religion
Sikh
Prefer not to say
Other Religion
Other
13
Caring ResponsibilitiesPlease tick all that apply
None
Primary carer of a child/children under 18
Primary carer of a disabled child/children
Primary carer of a disabled adult (over 18)
Primary carer of an older person
Secondary carer (another person carries out primary caring responsibilities)
Prefer not to say
Other
14
Socio-Economic BackgroundPlease select the option that best describes the occupation of the main/highest income earner in your household when you were aged 14.
Clerical and intermediate occupations e.g secretary, personal assistant, nursery nurse, office clerk, call centre agent
Middle or Junior managers e.g. office manager, warehouse manager, restaurant manager
Modern professional occupations e.g. teacher, nurse, social worker, artist, musician, software designer
Routine manual and service occupations e.g. van driver, cleaner, porter, waiter/waitress, bar staff
Semi-routine manual and service occupations e.g. postal worker, security guard, machine worker, receptionist, sales assistant
Technical and craft occupations e.g. fitter, plumber, printer, electrician
Traditional professional occupations e.g. accountant, solicitor, scientist, medical practitioner
Long-term unemployment e.g claimed Jobseeker's Allowance or earlier unemployment benefit for more than a year
This question does not apply to me
Prefer not to say
15
Socio-Economic Background - what type of school did you mainly attend between the ages of 11 and 16?
Attended school outside the UK
Independent or fee-paying school- bursary
Independent or fee-paying school- no bursary
State-run or state funded school- non-selective
State-run or state funded school- selective on faith, academics or other grounds
Prefer not to say
Other
16
Socio-economic Background - during your time at school, were you a recipient of the free school meals programme?
Yes
No
Prefer not to say
17
Anything else you would like to let us know about?
Huge
Large
Normal
Small
Ok
Ok
Should be Empty: