REPS - Equal Opportunities Form EQUAL OPPORTUNITIES We would now like you to complete our Diversity monitoring form which DOES NOT FORM PART OF YOUR APPLICATION and will be stored separately from your REPs application documents. Thank you for your assistance in completing this form. Date of birth * Gender * MaleFemaleNon-binaryOtherPrefer not to say Is your gender identity the same as the one assigned to you at birth? * YesNoPrefer not to say ETHNIC ORIGIN Please select your ethnic group * Asian or Asian British - BangladeshiAsian or Asian British - ChineseAsian or Asian British - IndianAsian or Asian British - PakistaniOther Asian backgroundBlack or Black British - CaribbeanBlack or Black British - AfricanOther Black/African/Caribbean backgroundMixed - White and AsianMixed - White and Black AfricanMixed - White and Black CaribbeanOther Mixed/Multiple Ethnic backgroundArabOther Ethnic backgroundWhite - BritishWhite - Gypsy or Irish travellerWhite - IrishWhite - OtherPrefer not to say SEXUAL ORIENTATION Please select your sexual orientation * AsexualBisexualGayHeterosexualLesbianPansexualPrefer not to say DISABILITY Disability * No disabilityYou have a social/communication impairment such as Asperger/'s syndrome/other autistic spectrum disorderYou are blind or have a serious visual impairment uncorrected by glassesYou are deaf or have a serious hearing impairmentYou have a long standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease or epilepsyYou have a mental health condition such as depression, schizophrenia or anxiety disorderYou have a specific learning difficulty such as dyslexia, dyspraxia or AD(H)DYou have a physical impairment or mobility issues, such as difficulty moving your arms or using a wheelchair or crutchesYou have a disability, impairment or medical condition that is not listed aboveYou have two or more impairments/and or disabling medical conditionsYou have a disability not listed abovePrefer not to say Should you wish to provide more information, please do so here: Do you have significant caring responsibilities? * YesNoPrefer not to say Should you wish to provide more information, please do so here: SOCIO-ECONOMIC BACKGROUND Socioeconomic status is not a protected characteristic under the Equality Act 2010. However, in the context of UKRI funded doctoral training, it is an important social issue. Did any of your parent(s) or guardian(s) complete any of the following? * Undergraduate degreeMasters degreeDoctoral degreeNone of the aboveI don't knowPrefer not to say Please select the type of school you mainly attend between the ages 11 and 16 * A state-run or state funded school - selective on academic, faith or other groundsA state-run or state-funded school - non-selectiveIndependent or fee paying schoolHome schooledAttended school outside of the UKI don't knowPrefer not to say During your school years did your household receive income support? * YesNoI don't knowPrefer not to say During your school years did you receive free school meals? * YesNoI don't knowPrefer not to say Please enter the postcode of the house you grew up in * Please put N/A if you grew up outside of the UK, don't remember your postcode or would prefer not to say. If you are human, leave this field blank. Δ
