Mercury Creatives Equality & Diversity Form | Mercury Theatre Colchester

What is your gender?*

Woman
Man
Non-binary
Prefer not to say
Prefer to self-describe (let us know below)

What is your gender identity?

Is your gender identity different from the sex you were assigned at birth?

Yes
No
Prefer not to say

What is your age?*

What is your ethnic background?*

Please tick the appropriate box that indicates your cultural background.

What is your ethnic background?

Equality Act 2010

A person is covered under the Equality Act 2010 if they have a physical or mental impairment, which has a substantial and long term (over 12 months) adverse effect on their ability to carry out normal day to day activities. People who have had such a disability in the past are also covered.

Do you consider yourself to be covered by this act?*

Yes
No
Prefer not to say

If yes, please give details of the effect or impact of your disability or health condition on your ability to give your best at work

What is your sexual orientation?*

What is your sexual orientation?

Do you have caring responsibilities?*

None
Primary carer of a child/children (under 18)
Primary carer of a disabled child/children
Primary carer of disabled adult (18+)
Primary carer of older person
Secondary carer (another person carries out the main caring role)
Prefer not to say