24/25 Transform Equal Opportunities Monitoring Form Transform is committed to meeting the aims set out in our Equality and Inclusion policy and monitoring the effectiveness of this. Collating data enables us to build a more accurate picture of who we are working with and to submit information that our grant funders ask for. We would be grateful if you could complete the following form. Any information you provide will be treated as strictly confidential. It will be anonymised and only used for evaluation purposes. Question Title * 1. How are you engaged with Transform? Question Title * 2. What is your age? 16-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+ Prefer not to say Question Title * 3. What is your ethnicity or cultural background? Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Indian Asian/Asian British - Pakistani Any other Asian background Black/Black British - Black African Black/Black British - Black Caribbean Any other Black background Mixed background - Asian & white Mixed background - Black African & white Mixed background - Black Caribbean & white Any other Mixed background White/White British - Gypsy, Roma or Irish traveller White/White British - White British White/White British - White Irish Any other White background Any other Background - Arab Any other Background - Latin American Any other Background Prefer not to say Not known Other (please specify) Question Title * 4. Do you identify as a D/deaf and/or disabled person, or have a long term health condition? Yes No Prefer not to say Question Title * 5. Do you identify as Neurodivergent? Being Neurodivergent could include Dyslexia, ADHD. Yes No Prefer not to say Question Title * 6. What best describes your current or most recent occupation? Clerical and intermediate occupations such as: secretary, personal assistant, call centre agent, clerical worker, nursery nurse. Full-time education such as: studying for a degree or apprenticeship Long term unemployed (claimed Jobseeker’s Allowance or earlier unemployment benefit for more than a year). 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. Retired 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. Senior, middle or junior managers or administrators such as: finance manager, chief executive, large business owner, office manager, retail manager, bank manager, restaurant manager, warehouse manager. 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. Technical and craft occupations such as: motor mechanic, plumber, printer, electrician, gardener, train driver. Not applicable (eg not currently working and not claiming benefits related to unemployment) Prefer not to say Not known Other (please specify) Question Title * 7. What best describes the main/highest income earner role in your household when you were 14? Clerical and intermediate occupations such as: secretary, personal assistant, call centre agent, clerical worker, nursery nurse. Full-time education such as: studying for a degree or apprenticeship Long term unemployed (claimed Jobseeker’s Allowance or earlier unemployment benefit for more than a year). 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. Retired 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. Senior, middle or junior managers or administrators such as: finance manager, chief executive, large business owner, office manager, retail manager, bank manager, restaurant manager, warehouse manager. 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. Technical and craft occupations such as: motor mechanic, plumber, printer, electrician, gardener, train driver. Not applicable (eg not currently working and not claiming benefits related to unemployment) Prefer not to say Not known Other (please specify) Question Title * 8. Do you currently reside in the UK? Yes No Question Title * 9. If Yes, what is your postcode? Question Title * 10. If not, what country do you reside? Question Title * 11. What is your sex? Female Intersex Male Prefer not to say Question Title * 12. Is your gender identity the same as the sex you were assigned at birth? No Yes Prefer not to say Question Title * 13. How would you describe your gender identity? Man Non-binary Woman Prefer to self-describe [free text] Not applicable Prefer not to say Question Title * 14. How would you describe your sexual orientation? Bisexual Gay Man Gay Woman / Lesbian Heterosexual / Straight Queer Prefer to self-describe [free text] Prefer not to say Not known Done