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Equality & Diversity Monitoring Information

Literature Wales aims to provide fair and equal access to all its activities. This questionnaire will help us monitor the effectiveness of our Equality Policies, 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?

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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. How would you describe your ethnic group?

Asian: Bangladeshi

Asian: Chinese

Asian: Indian

Asian: Pakistani

Black: African

Black: Caribbean

Mixed/Multiple Ethnic Groups: White and Asian

Mixed/Multiple Ethnic Groups: White and Black African

Mixed/Multiple Ethnic Groups: White and Black Caribbean

Other Ethnic Group: Arab

Other Ethnic Group: Gypsy or Irish Traveller

Prefer not to say

White: Any white background

Prefer to self-describe / other:

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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. Are you?

Tick all that apply

In full time employment

In part-time employment

Self-employed/Freelance

In full time education

In part-time education

Not in employment

Prefer not to say

Other (please specify)

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* 7. 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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* 8. 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

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* 9. 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.

Equality & Diversity Monitoring Information

Question Title

* 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. How would you describe 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. Are you?

Tick all that apply

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* 7. If not in employment, are you?

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

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

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* 9. 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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* 10. 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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* 11. What is the first part of your postcode?

E.g., SA32

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* 12. Please note any other languages you can understand, speak, read or write.

Equality & Diversity Monitoring Information

Question Title

* 1. What is your gender?

Question Title

* 2. What is your age?

Question Title

* 3. What is your nationality?

Question Title

* 4. How would you describe your ethnic group?

Question Title

* 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. Are you?Tick all that apply

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* 7. If not in employment, are you?

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

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* 9. 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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* 10. 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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* 11. What is the first part of your postcode? E.g., SA32

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* 12. Please note any other languages you can understand, speak, read or write.

* 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.)

* 6. Are you?

Tick all that apply

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

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

* 9. Can you understand, speak, read and / or write Welsh?
Please rate your level of fluency (1 least fluent – 4 most fluent)

* 10. Can you understand, speak, read and / or write English?
Please rate your level of fluency (1 least fluent – 4 most fluent)

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

E.g., SA32