2024 Equality & Diversity Monitoring (18 + Under)

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We want to make sure everyone at Peak is treated with respect and is protected from discrimination. Through equality and diversity monitoring forms, we are looking to understand who Peak's work is serving. The information you share with us is confidential and kept securely. It is collected anonymously and you do not have to share anything you do not want to. If you have any feedback on this form, or questions, please email ellen@peak.cyrmu

What programme are you part of at Peak? *

Play/Ground

Peak Peers

Other:

What's your age? *

Which of the following best describes your gender identity? If you'd like to self-describe please select the 'other' option and write in. 
*

Female

Male

Non-binary

I'd prefer not to say

Other:

Trans is a term for people whose gender identity is different to the sex category they were assigned at birth. Using this definition, do you consider yourself Trans?
*

Yes

I'm not sure

I'd rather not say

How would you describe your ethnicity?
*

Asian / Asian British

Black / African / Caribbean / Black British

White

Mixed / Multiple Ethnic Groups

Prefer not to say

Other:

How would you describe your national identity? 
*

Welsh

British

English

Scottish

Northern Irish

Prefer not to say

Other:

Please tell us about your Welsh language skills - select as appropriate
*

Welsh learner

Fluent Welsh speaker

Understand and speak some Welsh

Required

Do you identify as disabled or do you have a long-term health condition?
*

Yes

Prefer not to say

Do you have caring responsibilities (do you care for someone in your family or community regularly)?
*

Yes

Prefer not to say

Other:

Have you ever been in care (e.g. foster care or residential care)?
*

Yes

Prefer not to say

What is the occupation of your main household earner?
*

Modern professional & traditional professional occupations such as: teacher, nurse, physiotherapist, social worker, musician, police officer (sergeant or above), software designer, accountant, solicitor, medical practitioner, scientist, civil / mechanical engineer.

Senior, middle or junior managers or administrators such as: finance manager, chief executive, large business owner, office manager, retail manager, bank manager, restaurant manager, warehouse manager.

Clerical and intermediate occupations such as: secretary, personal assistant, call centre agent, clerical worker, nursery nurse.

Technical and craft occupations such as: motor mechanic, plumber, printer, electrician, gardener, train driver.

Routine, semi-routine manual and service occupations such as: postal worker, machine operative, security guard, caretaker, farm worker, catering assistant, sales assistant, HGV driver, cleaner, porter, packer, labourer, waiter/waitress, bar staff.

Long-term unemployed (claimed Jobseeker’s Allowance or earlier unemployment benefit for more than a year).

Small business owners who employed less than 25 people such as: corner shop owners, small plumbing companies, retail shop owner, single restaurant or cafe owner, taxi owner, garage owner.

Other such as: retired, this question does not apply to me, I don’t know.

I prefer not to say

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