Current Start Preview Complete Information message Filling out this form will email the relevant department Equality Opportunities Monitoring Under the Equality Act 2010, the Council has a responsibility to ensure that we do not unfairly discriminate in the services we provide. In order to help us ensure that our Equal Opportunities Policy is working, would you please provide the following information by ticking the appropriate boxes. Providing this information is optional, and any you provide will be treated in the strictest confidence and will only be used for statistical monitoring, to help ensure our services are accessible to everyone. A little bit about you We want to make sure that we are getting views from right across Wolverhampton’s various communities. It would be helpful if you could tell us some things about yourself. This is a completely anonymous survey and all the feedback we get from individuals will be kept confidentially and finally destroyed safely. Completing the form is of course your choice but it would really help us. Age How old are you? Under 16 16-24 25-34 35-44 45-54 55-64 65+ Disability Do you have a disability which affects your day to day activities, which has lasted, or you expect to last, at least a year? Yes No Not sure prefer not to say Ethnic origin Are you: Select your raceAsianBlackDual HeritageWhiteOther ethnic group specify ethnic origin Bangladeshi Chinese Indian Pakistani Other Asian specify ethnic origin African Caribbean Other Black specify ethnic origin White and Asian White and Black African White and Black Caribbean Other Mixed background specify ethnic origin British Gypsy/Traveller Irish Other European Other White specify ethnic origin Arab Any other prefer not to say Religion Are you: Buddhist Christian Hindu Jewish Muslim Sikh Any other religion No religion prefer not to say Gender Identity Are you:? Woman Man Non-binary I use another term Prefer not to say Sexual Orientation Are you? Bi Gay man Lesbian/gay woman Heterosexual/straight I use another term prefer not to say Trans identity Are you Trans?? Yes No Prefer not to say 14739
