Equality and diversity monitoring form

2. How would you describe your national identity? *

3. What is your ethnic group? Ethnic origin categories are not about nationality, place of birth or citizenship. They are about the group to which you as an individual perceive you belong. Choose one option that best describes your ethnic group or background.

Black/African/Caribbean/Black British/Black Irish *

African Caribbean Any other Black/African/Caribbean background

Other ethnic group *

Arab Any other ethnic group Prefer not to say

4. The Equality Act 2010 defines disability as 'a physical or mental impairment that has a 'substantial' and 'long-term' negative effect on your ability to do normal daily activities'.

Would you consider yourself disabled under this definition? *

Yes No Prefer not to say

Thank you for taking the time to provide this information.

Equality and Diversity Monitoring Form