CPN | EDI Monitoring

Community Organisers is committed to equality and we strive to foster an inclusive and diverse movement. To monitor this, we ask everyone who joins the movement to help us by completing our diversity form.

You can skip this page and complete your submission by clicking here.

Please note:

any data from this form is anonymous (you cannot be identified from it) and the information is only processed internally.
completion of this form is voluntary; you do not have to answer any of the question(s).

Equal Opportunities and Diversity - CPN

What is your gender?
I self identify as:
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Age
What age group do you belong to?
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Sexual Orientation
Please indicate from the list which best describes your sexual orientation.
Other:
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Disability
Do you consider yourself to have a disability? A disabled person is defined under the Equality Act 2010 as someone with a ‘physical or mental impairment which has a substantial and long term adverse effect on that person’s ability to carry out normal day-to-day activities.’
If ‘Yes’ please state the type of impairment which applies to you. People may experience more than one type of impairment, in which case you may indicate more than one. If none of the categories apply, please mark ‘other’.
If ‘Yes’ please state the type of impairment which applies to you. People may experience more than one type of impairment, in which case you may indicate more than one. If none of the categories apply, please mark ‘other’.
- Physical Impairment
- Sensory Impairment
- Mental Health Condition
- Learning Disability / Difficulty
- Long-standing Illness
- Other
What is the effect or impact of your disability? Please write here:
PLEASE NOTE: The information in this form is for monitoring purposes only. If you believe you need a ‘reasonable adjustment’, then please discuss this with the National Member Organiser, or the person running your Social Action Hub.
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Ethnicity
Please indicate which ethnic group you consider yourself to belong? Please note: ethnic origin is not about nationality, place of birth, or citizenship. It is about the group to which you perceive you belong. Please tick the appropriate box
Please select
If you have selected ‘White’ please state which group you consider yourself to belong to:
Please select
If you have selected ‘Black’ please state which group you consider yourself to belong to:
Please select
If you have selected ‘Asian’ please state which group you consider yourself to belong to:
Please select
If you have selected ‘Mixed’ please state which group you consider yourself to belong to:
If you have selected ‘Other’ please state which group you consider yourself to belong to:
If you have selected ‘Other’ please state which group you consider yourself to belong to:
___________
Religion or Belief
Please indicate which religion or belief you consider yourself to belong to?
Please state which other religion you consider yourself to belong to:

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CPN | EDI Monitoring

Equal Opportunities and Diversity - CPN

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