Equalities Monitoring Form

Data protection statement:

Your privacy is important to us. Your data will be stored securely and will only be used in relation to the Queen’s Nurse Development Programme. It will not be shared with third parties for the purpose of marketing or other activity. The Queen's Nursing Institute Scotland will only use the information provided on this form if we wish to contact you to verify the information you have provided.

If your application is unsuccessful your data will be retained for no longer than six months, at which point it will be securely deleted. If your application is successful your data will be kept in accordance with GDPR.

For more information on your privacy rights please see our privacy policy or contact comms@qnis.org.uk for a copy.  Under the Data Protection Legislation, you have rights as an individual which you can exercise in relation to the information we hold about you. You can read more about these rights here.


1. How would you describe your age group? *


2. What is your ethnicity? *


3. Do you consider yourself to have a disability?
Under the Equality Act 2010, a disability is a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities. *


4. What is your religion or belief? *


5. What is your gender identity? *


6. What is your sexual orientation? *


7. What is your marital status? *