Artis Equal Opportunities Monitoring Form for Trustee Recruitment

Confidential

We are committed to providing equal opportunities for all in recruitment and during employment. We care deeply about inclusion so in order evaluate our progress, we collect data to measure this progress.

This monitoring form is voluntary but the information we collect is very useful in helping us to examine the diversity of our workforce to make informed decisions that support inclusion. This includes not discriminating under the Equality Act 2010, and building an accurate picture of the make-up of the team in encouraging equality and diversity. The information also aids information required for vital funding applications.

We would be grateful if you could respond to the questions outlined below, which will only take 5 minutes to complete.

Any information supplied will be treated in the strictest of confidence.

The information will only be accessed by necessary members of the Artis team. The data will be held securely and will not be distributed to any third parties. When this information is no longer required the procedures for disposing of the data with be followed in line with our Privacy Policy.

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* 1. What is your age?

18-24

25-34

35-44

45-54

55-64

65-74

75 or older

Prefer not to say

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* 2. Which of the following best describes you?

Female

Male

Non-binary

Prefer not to say

I prefer to use other language (please state)

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* 3. Is your gender identity the same as your gender/sex assigned at birth?

Yes

Prefer not to say

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* 4. What is your sexual orientation?

Asexual

Bisexual

Heterosexual

Homosexual

Pansexual

Prefer not to say

I self-identify as:

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* 5. Ethnicity - please select from the list below

Arab or Arab British

Asian or Asian British – Indian

Asian or Asian British – Pakistani

Asian or Asian British – Bangladeshi

Asian – Any other Asian background (please specify below)

Black or Black British – Caribbean

Black or Black British – African

Black – Any other black background (please specify below)

Chinese or Chinese British

Latin American

Mixed – White & Black Caribbean

Mixed – White & Black African

Mixed – White & Asian

Mixed – Any other mixed background (please specify below)

White – British

White – Irish

White – Gypsy/Irish Traveller

White – Other background (please specify below)

Any other ethnic origin (please specify below)

Prefer not to say

Other (please specify)

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* 6. What is your religion or belief?

Buddhist

Christian

Hindu

Jewish

Muslim

Sikh

Prefer not to say

No religion or belief

Other religion or belief (please specify)

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* 7. Disability:
Do you consider yourself to have a disability or health condition in accordance with the Equality Act 2010?

The Equality Act 2010 defines a disability as "a physical or mental impairment which has a substantial and long-term adverse effect on your ability to carry out normal day to day activities". 'Substantial' is more than minor or trivial, e.g. it takes much longer than it usually would to complete a daily task like getting dressed. 'Long-term' means 12 months or more, e.g. a breathing condition that develops as a result of a lung infection.

Yes

Prefer not to say

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* 8. If you ticked yes, please state the impairment(s) which apply to you

Physical impairment

Sensory impairment

Mental health condition

Learning difficulty/disability

Long-standing illness

Prefer not to say

Other (please specify)

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* 9. Do you consider yourself to be neurodiverse? [If yes, please tick all that apply.]

Attention Deficit (Hyperactive) Disorder AD(H)D

Autistic Spectrum Disorder (ASD)

Dyslexia

Dyscalculia

Dyspraxia

Obsessive Compulsive Disorder (OCD)

Prefer not to say

Another form of neurodiversity (e.g., Tourette’s Syndrome) Please specify

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* 10. Do you have caring responsibilities? (Please tick all that apply)

Primary caregiver of a child/children (under 18)

Primary caregiver of disabled child/children (under 18)

Primary caregiver of disabled adult (18 and over)

Primary carer of an older person

Secondary carer

None

Prefer not to say

Other (please specify)

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* 11. Are you married or in a civil partnership?

Yes

Prefer not to say