BT.02b
Equal Opportunities Monitoring Form
Crossroads tries to provide
services to carers from all backgrounds, nationalities and ethnic groups. To help us to check how well we are doing in
that, we would like you to complete this form.
Name of Carer:
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How would you describe your ethnicity? |
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White |
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Asian or Asian British |
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British |
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Bangladeshi |
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Irish |
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Indian |
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Any other white background
(please specify:) |
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Pakistani |
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Any other Asian background (please specify:) |
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Black or Black British |
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Mixed |
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African |
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White and Black Caribbean |
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Caribbean |
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White and Black African |
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Any other black background
(please specify:) |
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White and Asian |
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Any other mixed background
(please specify:) |
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Chinese |
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Other ethnic group |
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Chinese |
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Other ethnic group (please
specify:) |
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If
you would like to further describe your ethnicity, please do so here: |
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