Equalities Monitoring Form - Amazon Web Services



Equality and Diversity Monitoring FormChildren’s Hospice Association Scotland aims to provide equal opportunities and fair treatment for all volunteers.The information below is anonymous and will not be stored with any identifying information about you. All details are held in accordance with the Data Protection Act 1998.We would like you to complete this form in order to help us understand who we are reaching and to better serve everyone in our community. The information will be used to provide an overall profile analysis of our volunteer base. This will help to make sure that CHAS has an equal and diverse volunteer base, allowing us to provide vital services for children and young people with life-shortening conditions. You do not have to complete this form if you do not wish to do so. If you would like to complete the form but would like it in an alternative format or would like help in completing it, please contact a member of our staff.Please complete each section by ticking the relevant options below:Date of Birth …………………………………………Which one of the following best describes your gender?? Man? Woman? In another way? Prefer not to say? If you describe your gender with another term, please provide this here ________Sexual Orientation? Heterosexual / straight? Gay / lesbian? Bisexual? Other? Prefer not to sayReligion? No religion? Christian? Buddhist? Hindu? Sikh? Jewish? Muslim? Prefer not to say? Any other religion or beliefHow would you describe your ethnic origin?White:? English? Welsh? Scottish? Northern Irish? British? Irish? Gypsy or Irish Traveller? Other white background: …………………………………………………………………Mixed / multiple ethnic groups:? White and Black Caribbean? White and Black African? White and Asian? Any other mixed background: ……………………Asian / Asian British:? Indian? Pakistani? Bangladeshi? Chinese? Any other Asian background: ……………………………………………………………Black / African / Caribbean / Black British:? African? Caribbean? Any other Black / African / Caribbean background: …………………………………...Other ethnic group:? Arab? Any other ethnic background? Prefer not to sayDo you consider yourself to have a disability?Section 6 (1) of the equality act states that a person has a disability if:That person has a physical or mental impairment, andThe impairment has a substantial and long-term adverse effect on that person’s ability to carry out normal day-to-day activities.? Yes? No? Prefer not to say ................
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