Strategic Housing Investment Plan 2010 - Falkirk Council
Strategic Housing Investment Plan 2010 - Falkirk Council
Strategic Housing Investment Plan 2010 - Falkirk Council
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<strong>Strategic</strong> <strong>Housing</strong> <strong>Investment</strong> <strong>Plan</strong> 2011 - 2016 Appendix 3b<br />
Equalities Information<br />
DIVERSITY MONITORING FORM 2009<br />
1. Name _______________________________<br />
2. Gender<br />
(a) Are you: Female Male<br />
3. Age<br />
I am ____ years old and my date of birth is: __/___/____<br />
4. Relationship Status<br />
What is your relationship status?<br />
1 Never married and never registered a same sex civil partnership<br />
2 Married 7 In a registered same-sex civil partnership<br />
3 Separated, but still 8 Separated, but still legally in a same-sex<br />
legally married civil partnership<br />
4 Divorced 9 Formerly in a same-sex civil partnership<br />
which is now legally dissolved<br />
5 Widowed 10 Surviving partner from a same-sex civil<br />
partnership<br />
6 Living with Partner 11 Prefer not to say<br />
5. Religion<br />
What religion, religious denomination or body do you belong to?<br />
1 None 7 Church of Scotland<br />
2 Roman Catholic 8 Other Christian<br />
3 Muslim 9 Buddhist<br />
4 Sikh 10 Jewish<br />
5 Hindu 11 Pagan<br />
6 Another religion, please write in _________________________<br />
12 Prefer not to say<br />
6. National Identity<br />
How would you describe your national identity?<br />
* Tick all that apply<br />
1 Scottish 5 English<br />
2 British 6 Polish<br />
3 Indian 7 Other, please write in ________________<br />
4 Prefer not to say<br />
7. Ethnic Group<br />
What is your ethnic group? *<br />
* Choose ONE section from A to E, then tick ONE box which best describes<br />
your ethnic group or background.<br />
A White<br />
1 Scottish 6 English