Equality Monitoring Form

Voluntarily and anonymously gathers demographic details on gender, ethnicity, age, religion, and caring responsibilities. Lets organizations measure the diversity of their processes and spot inclusion gaps.

Use this template

Please tick the option relevant to you

Do you relate to any of these statements? You can choose more then one.

I have a disability I have a long-term health condition I consider myself neurodivergent None of these Prefer not to say

If you would prefer to self-identify, please detail:

What best describes your gender?

Woman Man Non-binary Prefer not to say

If you would prefer to self-identify, please detail:

Are you the same gender as assigned to you at birth?

Yes No Prefer not to say

Asian/Asian British

Black/African/Caribbean/Black British

African Caribbean Any other Black background

Mixed/Multiple Ethnic Groups

White and Black Caribbean White and Black African White and Asian Any other mixed background

White

British Irish Gypsy or Traveller Any other White background

Other Ethnic Group

Arab Latin American Any other group Prefer not to say

What is your sexual identity?

If other, please specify:

What was the occupation of your main household earner when you were aged about 14?

If other, please specify:

Do you have any caring responsibilities?

None Caring for children Caring for a disabled family member Caring for an elderly relative Prefer not to say

Are you returning to work following an extended period (12 months or more) of absence?

Yes No Prefer not to say

If yes, select one of the following to describe the reason for your career break:

If other, please specify:

What is your working pattern?

Full-time Part-time Flexible hours Job share

If you were a trainee on this project, how did you hear about the opportunity?

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