Exit Equality and Diversity Form The British Dietetic Association wants to meet the aims and commitments set out in its equality policy. This includes not discriminating under the Equality Act 2010, and building an accurate picture of the make-up of the workforce in encouraging equality and diversity.Please complete this form alongside your application. Details will be kept private and separate from your application. Question Title * 1. What is your gender identity? Woman Man Non-binary Prefer to self-describe (please specify) Question Title * 2. Do you identify as transgender or non-binary? Yes No Question Title * 3. Is your gender the same as your sex registered at birth? Yes No Question Title * 4. What is your sexual orientation? Asexual Bisexual Gay Heterosexual (straight) Lesbian Pansexual Queer Prefer not to specify None of the above, please specify Question Title * 5. What is your racial or ethnic identity? (Select all that apply.) White, British Asian or Asian British White, European Black, Africa, Caribbean or Black British White, other Black, other Middle Eastern or North African American, South American or Hispanic Mixed or Multiple ethnic groups Other Ethnic Groups Other or your own description (please specify) Question Title * 6. Where where you born (country/nation)? Prefer not to say Please specify: Question Title * 7. How old are you? 16-24 25-29 30-34 35-39 40-44 44-49 50-54 55-59 60-64 prefer not to say Question Title * 8. Do you have a disability? Yes No Prefer not to say If yes, please specific?(if you require any adjustments please make sure your line manager is aware, to support you) Question Title * 9. What is the primary language you speak at home? Question Title * 10. Are you a primary caregiver for any of the following people? (Select all that apply) Child or children under age 3 Child or children age 3 to 11 Child or children age 12 to 17 Adult(s) (age 18+) in your home Adult(s) (age 18+) outside your home None of the above Question Title * 11. Do you consider yourself a first generation college graduate? Yes No Question Title * 12. Have you ever served in the military? Yes No Question Title * 13. What is your religion or belief? Christian Muslim Buddhist Hindu Sikh Jewish Spiritual Prefer not to say Other, please specific? Question Title * 14. Do your beliefs/ethics require any adaptations or support from an employer? Yes No Maybe Please specify? Question Title * 15. Which of the following best describes your current job level? Individual contributor Manager Senior manager Vice president C-level/president/owner Done
