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Equal Opportunities Monitoring - Public Life Applications
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1.
Question 1.
Nationality
2.
Question 2.
How would you describe your race or ethnicity?
Mixed ethnic background
Asian, Indian
Asian, Pakistani
Asian, Bangladeshi
Asian, any other Asian backgroud
Black African
Black Caribbean
Black, any other Black background
White British
White Irish
White, Any other White background
Gypsy or Irish Traveller
Arab
Prefer not to say
Other (please specify):
This is required
Input box for - Other (please specify):
3.
Question 3.
How would you describe your gender?
Female
Transgender
Male
Prefer not to say
4.
Question 4.
What is your age range?
0-24
25-64
65+ years
Prefer not to say
5.
Question 5.
Do you consider yourself to have a disability?
Yes
No
Prefer not to say
6.
Question 6.
Do you have a particular religion or belief?
No Religion
Buddist
Christian
Hindu
Jewish
Muslim
Sikh
Prefer not to say
Other (please specify):
This is required
Input box for - Other (please specify):
7.
Question 7.
How would you describe your sexuality?
Heterosexual
Gay or Lesbian
Bisexual
Prefer not to say
8.
Question 8.
Welsh Language - Are you ...
Fluent Welsh Speaker
Speak Basic Welsh
Don't speak Welsh
Prefer not to say