Inclusion Monitoring Form

Choose one section from the below the most appropriate box to indicate your cultural background.
Dependents - are you a carer?

Carers are people with caring responsibilities that have a substantial impact on their working lives. They provide care for or support disabled, elderly or sick partners, relatives or friends who are unable to care for themselves.
Do you have responsibility for other dependents? (e.g., children)

Please tell us about the occupation of your main household earner when you were aged 14. If this question does not apply to you (because, for example, you were in care at this time), you can indicate this below.

Please tick one box to show which best describes the sort of work the highest earner in your household undertook at this time.

Disability - Do you consider yourself to have a disability within the meaning of the Equality Act?

The Equality Act 2010 defines a person as having a disability if they have a physical or mental impairment which has a substantial long-term adverse effect on their ability to carry out normal day-to-day activities. A long-term adverse effect is one that has lasted 12 months or more or is likely to do so. 
Is your gender identity the same as the sex that you were assigned at birth?

The following questions are designed to gather trans data i.e. whether your gender identity and/or gender expression differs from your birth sex. A trans person may or may not seek to undergo gender reassignment hormonal treatment/surgery.

Thank you for taking the time to complete this form.