Equal Opportunity Monitoring Form
By completing and returning this form you are consenting for this to be used for Equal Opportunities Monitoring purposes. Provision of this information will not adversely affect an individual's chances of selection or any other decision related to their submission. This Equal Opportunities Monitoring Form will be processed in an anonymised format. Analysing this data helps us take appropriate steps to avoid discrimination and improve equality and diversity.
This Form Relates To An Application For:
North Star Shorts
Next Wave
The Bigger Picture
Age
What is your age?
18-20
21-29
30-39
40-49
50-59
60 or over
Prefer not to say
Gender
What best describes your gender?
Male
Female
Non Binary / Gender Queer
Prefer not to say
Prefer to self-identify
If you would prefer to self-identify, please specify:
Is this the gender you were assigned at birth?
Yes
No
Prefer not to say
Sexual Identity
What is your sexual identity?
Asexual
Bisexual
Gay Man
Gay Woman/Lesbian
Straight/Heterosexual
Prefer to self-identify
Prefer not to say
Relationship Status
Please select the most relevant
Married / Civil Partnership
Single
Widowed / A surviving civil partner
Divorced / Formerly a Civil Partnership (now legally dissolved)
Prefer not to say
Ethnic Origin
Asian/Asian British
Asian - Bangladeshi
Asian - Chinese
Asian - Indian
Asian - Pakistani
Asian - Another Asian/South Asian/East Asian/South East Asian backgrounds
Black/African/Caribbean/Black British
Black/Black British - African
Black/Black British - Caribbean
Black/Black British - Any other Black/African/Caribbean backgrounds
Mixed/Multiple Ethnic Groups
Mixed - Asian & White
Mixed - Black African & White
Mixed - Black Caribbean & White
Mixed - Any other Mixed/Multiple Ethnic Group backgrounds
White
White - Scottish
White - British
White - English
White - Welsh
White - Northern Irish
White - Gypsy or Irish Traveller
White - Irish
White - Roma
White - Any other White backgrounds
Other Ethnic Group
Other - Arab
Other - Jewish
Other - Middle Eastern & North African Heritage
Other - West and Central Asian Heritage
Other - Any Other Ethnic Group backgrounds
Prefer not to say
Not Known
Disability & Access
The Equality Act 2010 defines a disability as any long-term impairment which has a substantial adverse effect on your ability to carry out day-to-day activities. An effect is long-term if it has lasted, or is likely to last, more than 12 months.
Do you consider yourself to have a disability or health condition?
Yes
No
Prefer Not to Say
If yes, what best describes your disability, impairment, learning difference or long-term condition? If yes, tick all that apply.
Blind or a serious visual impairment uncorrected by glasses
Deaf or serious hearing impairment
General learning disability (such as Down’s syndrome)
Long-standing illness or health condition such as cancer, chronic heart disease, diabetes, epilepsy, HIV or multiple sclerosis
Mental health condition, such as depression, schizophrenia, or anxiety disorder
Physical impairment or mobility issues, such as difficulty using arms or using a wheelchair or crutches
Two or more impairments and/or long-term conditions
A disability, impairment, or long-term condition that is not listed above (including a hidden disability not listed above)
I don’t relate to any of these
Prefer not to say
Prefer to self describe
If you would prefer to self describe, please detail:
Do you consider yourself to be neurodiverse? If yes, please tick all that apply.
Attention Deficit (Hyperactive) Disorder (AD(H)D)
Autistic Spectrum Disorder (ASD)
Dyslexia
Dyscalculia
Dyspraxia
Obsessive Compulsive Disorder (OCD)
I don’t relate to any of these
Prefer not to say
Another form of neurodiversity (e.g., Tourette’s Syndrome) Please describe
If you would prefer to self describe, please detail:
Religion/Belief
What is your religion or belief?
Agnostic
Atheist
Buddhist
Christian
Hindu
Jewish
Muslim
Sikh
No Religion
Other
Prefer not to say
Not Known
If other, please specify:
Socioeconomic & Class
When you were 14, what did the main income earner in your household do for a living? What was their main job? If this question does not apply to you (for instance, if you were in care), you can indicate this below.
Clerical and intermediate occupations such as: secretary, personal assistant, call centre agent, clerical worker, nursery nurse.
Modern professional & traditional professional occupations such as: teacher, nurse, physiotherapist, social worker, musician, police officer (sergeant or above), software designer, accountant, solicitor, medical practitioner, scientist, civil / mechanical engineer.
□ Middle or junior manager e.g., office manager, warehouse manager, restaurant manager
□ Senior manager/ administrator e.g., finance manager, chief executive
Small business owners who employed less than 25 people such as: corner shop owners, small plumbing companies, retail shop owner, single restaurant or cafe owner, taxi owner, garage owner.
Routine, semi-routine manual and service occupations such as: postal worker, machine operative, security guard, caretaker, farm worker, catering assistant, sales assistant, HGV driver, cleaner, porter, packer, labourer, waiter/waitress, bar staff.
Technical and craft occupations such as: motor mechanic, plumber, printer, electrician, gardener, train driver.
Long-term unemployed (claimed Jobseeker’s Allowance or earlier unemployment benefit for more than a year)
This question does not apply due to being care experienced
Prefer not to say
Other, please specify
If other, please specify:
Caring Responsibilities
Do you have any caring responsibilities?
Primary carer of a child or children (under 18)
Primary carer of disabled adult (18 and above)
Primary carer of disabled child or children
Primary carer of older person (65 and above)
Secondary carer
None
Prefer not to say
Not Known
Region
Which of these regions best describes your primary base?
Aberdeen City
Aberdeenshire
Angus
Argyll and Bute
City of Edinburgh
Clackmannanshire
Dumfries and Galloway
Dundee City
East Ayrshire
East Dunbartonshire
East Lothian
East Renfrewshire
Eilean Siar (Western Isles)
Falkirk
Fife
Glasgow City
Highland
Inverclyde
Midlothian
Moray
North Ayrshire
North Lanarkshire
Orkney
Perth and Kinross
Renfrewshire
Scottish Borders
Shetland
South Ayrshire
South Lanarkshire
Stirling
West Dunbartonshire
West Lothian
None
Prefer Not To Say
Submit
Should be Empty: