Copy of Equality and Diversity Monitoring Form: Job applicants 2025-26

Literature Wales aims to provide fair and equal access to all its activities. This questionnaire will help us monitor the effectiveness of our Equality Policy, and how we are complying with the 2010 Equality Act. Completion of this anonymous form is voluntary.

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* 1. What is your gender?

Male

Female

Non-binary

Prefer not to say

Other (please specify)

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* 2. What is your age?

16 - 24

25 - 29

30 - 34

35 - 39

40 - 44

45 - 49

50 - 54

55 - 59

60 - 64

65 or over

Prefer not to say

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* 3. What is your nationality?

Welsh

British

English

Scottish

Northern Irish

Irish

Prefer not to say

Other (please specify)

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* 4. What is your ethnic group?

White: Any White background

Asian: Chinese

Mixed/Multiple Ethnic Groups: White and Black Caribbean

Mixed/Multiple Ethnic Groups: White and Black African

Mixed/Multiple Ethnic Groups: White and Asian

Black: African

Black: Caribbean

Asian: Indian

Asian: Pakistani

Asian: Bangladeshi

Other Ethnic Group: Arab

Other Ethnic Group: Gypsy or Irish Traveller

Prefer not to say to all of the above

Any other ethnic group (please specify)

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* 5. Do you have any long-standing physical or mental health condition, illness, impairment or disability?
(i.e. has lasted or is expected to last at least 12 months and adverse effect on your ability to carry out normal day-to-day activities.)

Yes

Prefer not to say

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* 6. Can you understand, speak, read and / or write Welsh? (please rate your level of fluency (1 least fluent - 4 most fluent

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 7. Can you understand, speak, read and / or write English? (please rate your level of fluency (1 least fluent - 4 most fluent

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 8. Please state any other languages you can understand, speak, read and/or write

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* 9. Are you?

In full time employment

In part-time employment

Self-employed/Freelance

Not in employment

Prefer not to say

Other (plese specify)

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* 10. If not in employment, are you?

Studying

Retired

A stay at home parent

Unable to work due to an illness or disability

Receiving one or more Benefits or Allowances (including Universal Credit, Carers Allowance, PIP, University or College Hardship Fund but excluding non means tested Allowances)

Prefer not to say

Not applicable

Other (please specify)

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* 11. Would you say your annual household income is:

(This guide may help you identify average income levels.)

Higher than average

Around average

Lower than average

Not applicable

Prefer not to say

Copy of Equality and Diversity Monitoring Form: Job applicants 2025-26

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* 1. What is your gender?

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* 2. What is your age?

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* 3. What is your nationality?

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* 4. What is your ethnic group?

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* 5. Do you have any long-standing physical or mental health condition, illness, impairment or disability?
(i.e. has lasted or is expected to last at least 12 months and adverse effect on your ability to carry out normal day-to-day activities.)

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* 6. Can you understand, speak, read and / or write Welsh? (please rate your level of fluency (1 least fluent - 4 most fluent

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* 7. Can you understand, speak, read and / or write English? (please rate your level of fluency (1 least fluent - 4 most fluent

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* 8. Please state any other languages you can understand, speak, read and/or write

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* 9. Are you?

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* 10. If not in employment, are you?

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* 11. Would you say your annual household income is:

(This guide may help you identify average income levels.)

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* 12. What is the first part of your postcode?

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* 13. Where did you hear about this opportunity?

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* 1. What is your gender?

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* 2. What is your age?

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* 3. What is your nationality?

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* 4. What is your ethnic group?

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* 5. Do you have any long-standing physical or mental health condition, illness, impairment or disability?(i.e. has lasted or is expected to last at least 12 months and adverse effect on your ability to carry out normal day-to-day activities.)

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* 6. Can you understand, speak, read and / or write Welsh? (please rate your level of fluency (1 least fluent - 4 most fluent

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* 7. Can you understand, speak, read and / or write English? (please rate your level of fluency (1 least fluent - 4 most fluent

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* 8. Please state any other languages you can understand, speak, read and/or write

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* 9. Are you?

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* 10. If not in employment, are you?

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* 11. Would you say your annual household income is:(This guide may help you identify average income levels.)

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* 12. What is the first part of your postcode?

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* 13. Where did you hear about this opportunity?

* 5. Do you have any long-standing physical or mental health condition, illness, impairment or disability?
(i.e. has lasted or is expected to last at least 12 months and adverse effect on your ability to carry out normal day-to-day activities.)

* 11. Would you say your annual household income is:

(This guide may help you identify average income levels.)