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.
1.
How are you engaged with Transform?
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
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)
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
5.
Do you identify as Neurodivergent? Being Neurodivergent could include Dyslexia, ADHD.
Yes
No
Prefer not to say
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)
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)
8.
Do you currently reside in the UK?
Yes
No
9.
If Yes, what is your postcode?
10.
If not, what country do you reside?
11.
What is your sex?
Female
Intersex
Male
Prefer not to say
12.
Is your gender identity the same as the sex you were assigned at birth?
No
Yes
Prefer not to say
13.
How would you describe your gender identity?
Man
Non-binary
Woman
Prefer to self-describe [free text]
Not applicable
Prefer not to say
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
