* Required field

1. Your Full Name *

2. What is your ethnicity?
Asian: BangladeshiAsian: ChineseAsian: IndianAsian: PakistaniAsian: Any other Asian backgroundBlack: AfricanBlack: CaribbeanBlack: Any other Black backgroundMixed: Asian & WhiteMixed: Black African & WhiteMixed: Black Caribbean & WhiteMixed: Any other mixed ethnic backgroundWhite: British/English/Northern Irish/Scottish/WelshWhite: Gypsy or Irish TravellerWhite: RomaWhite: Any other White backgroundOther: ArabOther: Latin AmericanOther: Any other ethnic backgroundPrefer not to say
3. What is your gender identity?
ManWomanNon-binaryPrefer to self describePrefer not to say
4. Is the gender you identify with the same as your gender registered at birth?
YesNoPrefer not to say
5. Please select the age range that applies to you
16-2425-3435-4445-5455-64Prefer not to say
Disability

The Equality Act 2010 defines a person with a disability as someone who has a physical or mental impairment that has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities.

An effect is considered "substantial" if it is more than minor or trivial.

An effect is considered "long-term" if it has lasted for at least 12 months, it is likely to last for at least 12 months, or it is likely to last for the rest of the life of the person.

Normal day-to-day activities are not defined in the Act, but in general they are things that people do on a regular or daily basis, such as eating, walking, reading and writing.

Disabilities protected by the Equality Act include mental health conditions such as depression and anxiety, learning difficulties such as dyslexia, neuro-behavioural conditions such as autism, and health conditions such as cancer and diabetes.

6. Do you consider yourself to have a disability?
YesNoPrefer not to say