Equality and Diversity Monitoring Form

Gender

Q1What is your gender?
Q2Are you married or in a civil partnership?
Q3What is your age?
Q4What is your sexual orientation?
 

Ethnic Origin

Ethnic origin is not about nationality, place of birth or citizenship.  It is about the group to which you perceive you belong.  Please select from the following options:

Q5What is your ethnic origin?
Q6White
 
Q7Mixed/multiple ethnic groups?
 
Q8Asian/Asian British
 
Q9Black/African/Caribbean/Black British
 
Q10Other Ethnic Origin
 

Disability

Q11Do you consider yourself to have a disability or a health condition?
Q12

Religion and Belief

Q13What is your religion or belief?
 

Caring Responsibilities

Q14Do you have caring responsibilities?  If yes, please tick all that apply:

Thank you

Ganymede Solutions would like to thank you for taking the time to complete this survey.

Q15I consent to the above information being collected and processed as part of the Ganymede Equality, Diversity and Inclusion Policy.  
 
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