2026/27 Culture, Wellbeing & Economy Service: Equal Opportunities Monitoring Form

1. Please provide your postcode

Postcode

2. Please select your gender

(Required) Female Genderqueer Genderfluid Gender neutral Male Non-binary Transgender Other Prefer not to say

3. Please select your age group

(Required) 16 or under 17-24 25-34 35-44 45- 54 55-64 65+ Prefer not to say

4. Please select the ethnic group(s) you identify with

(Required) Arab Asian: Bangladeshi Asian: Indian Asian: Pakistani Any other Asian background British Black: African Black: Caribbean Any other Black background Chinese: Any Chinese background English Irish Latin American Mixed Ethnic Background: Asian and White Mixed Ethnic Background: Black African and White Mixed Ethnic Background: Black Caribbean and White Any other Mixed Ethnic Background Scottish Welsh White: Any White background Any Other Ethnic Background Prefer not to say

5. Do you consider yourself to have a disability or health condition?

Yes No Prefer not to say

6. Which of the following best describes your sexual orientation?

Heterosexual Gay Lesbian Bisexual Prefer not to say

7. 'Care experience’ refers to the experiences of individuals who spent part of their childhood in the care system due to situations beyond their control. It is anyone with any experience of care, no matter how short and no matter what age. Are you care experienced?

(Required) Yes No Prefer not to say

8. Do you have caring responsibilities?

(Required) Primary carer of a child/children (under 18) Primary carer of disabled child/children Primary carer of disabled adult (18 and over) Primary carer of older person None

9. What was the occupation of your main household earner when you were aged about 14?

(Required) modern professional and traditional professional occupations such as teacher, nurse, physiotherapist, social worker, musician, police officer (sergeant or above), software designer, accountant, solicitor, medical practitioner, scientist, civil engineer or mechanical engineer 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 clerical and intermediate occupations such as secretary, personal assistant, call centre agent, clerical worker, nursery nurse technical and craft occupations such as motor mechanic, plumber, printer, electrician, gardener, train driver 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 or waitress, bar staff long-term unemployed (claimed Jobseeker’s Allowance or earlier unemployment benefit for more than a year) small business owners who employed fewer than 20 people such as corner shop owners, small plumbing companies, retail shop owner, single restaurant or café owner, taxi owner, garage owner other such as retired, this question does not apply to me, I don’t know I prefer not to say No

EQUAL OPPORTUNITIES MONITORING FORM