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Equality and Diversity Monitoring Form for Individual Grant Applicants

Completion of this form is optional; however, it really helps the Foundation to identify any gaps in our service, so that our grants can reach as many people as possible. We'd be really grateful if you could take the time to complete this form.

The form is NOT part of the decision making process for applications. It is used to report separately to the Foundation's Trustees about the diversity of our applicants and grant recipients. All information is used in complete anonymity.

If you are completing this form on behalf of someone else (e.g. a child), please note that the questions on this form refer to the person for whom you are applying.

If you would like this form in large print or another format, then please call 0116 222 2200

    Do you consider your gender to be:


    Your age at time of application:


    Do you consider yourself to have a disability or long-term illness/health condition?


    Please tick any box or boxes below that apply to you. (Optional)


    What is your religion?

    What is your ethnicity?

    White background:

    Black / Black British background:

    Asian / Asian British background:

    Mixed or Dual Heritage:

    Other Ethnic Group:

    Which of the following best describes your sexual orientation?


    What is your current marital status?