Autumn 2015 – APPT Foundation Year

Equal Opportunity Monitoring Form

PLEASE NOTE: The completion of this form, in whole or in part, is entirely voluntary.  These details will be used for internal monitoring purposes only, to help us assess whether we are reaching all groups.  These details will not be used outside APPT.	
	
Please tick one box only:	
White		Mixed		
												
White
UK descent			White
Irish descent			White and
Black Caribbean			White and
Black African			
												
White
European descent			Any other White
background			White and
Asian			Any other Mixed
background			

Asian or Asian British		Black or Black British		
Indian			Pakistani			African			Caribbean			
												
Bangladeshi			Any other Asian
background			Other
(Please specify)					

Other Origin				
Chinese			Traveller			Other EEA National
(Please specify)					
												
Other
(Please specify)					UK National returning to UK
or arriving in UK for first time				

Please tick one box only:		Please tick one box only:	
Gay			Lesbian					Male				Female			
													
Heterosexual			Transsexual				Do you identify as a disabled person?	
													
Bisexual			Other					Yes				No			

		

Please tick one box only:		Please tick one box only:	
Christian			Muslim					Under 20				20 - 29			
													
Hindu			Jewish					30 – 59				60 - 74			
													
Buddhist			Sikh					75 and over						
													
None			Other