Y2_Take Three Equal Opportunity Monitoring Form_NW Applications

  • Equal Opportunity Monitoring Form for Next Wave

    By completing and returning this form you are consenting for this to be used for Equal Opportunities Monitoring purposes. This form will be processed in an anonymised format. Analysing this data helps us take appropriate steps to avoid discrimination and improve equality and diversity. Please only complete this form if you are applying for Next Wave and it MUST be completed by all members of your core team.

  • Age

  • Gender

    This is a trans inclusive form. The terms ‘woman’ and ‘man’ therefore include trans women and trans men.
  • What is your gender?
  • Is the gender you identify with the same as your sex registered at birth?

  • Sexual Identity

  • How would you describe your sexual orientation?

  • Relationship Status

  • Please select the most relevant

  • Nationality

  • Ethnic Origin

  • Asian/Asian British
  • Black/African/Caribbean/Black British
  • Mixed/Multiple Ethnic Groups
  • White
  • Other Ethnic Group

  • 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?
  • If yes, what best describes your disability, impairment, learning difference or long-term condition? Tick all that apply.
  • Do you consider yourself to be neurodiverse?
  • If yes, please tick all that apply.

  • Religion/Belief

  • What is your religion or belief?

  • 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.
  • What type of school did you mainly attend between the ages of 11 and 16?
  • What is the highest level of education you have successfully completed?

  • Caring Responsibilities

  • Do you have any caring responsibilities?

  • Returning to Work

  • Are you returning to work following an extended period (12 months or more) of absence?
  • If yes, select the primary reason from the following:

  • Gaelic Language

  • Which of these statements best applies to you?

  • Region

  • Which of these regions best describes your primary base?
  • Should be Empty: