Produced by Sport Structures Ltd for the British Wheel of Yoga

British Wheel of Yoga Equality Profile Form

The following questions are aimed at assisting in the formation of an equality action plan. The information provides us with a profile of the British Wheel of Yoga so that we can assess the representation of different groups and whether more needs to be done to achieve equality of opportunity. Please answer all questions as honestly as possible.

We will only use your name and contact details for entry into the prize draw. For every 50 responses we receive we will draw one free membership and one lucky member will also receive a free trip to our annual AGM/Congress which is worth £200.

Name:
Email or contact telephone number:

AgePlease tick the appropriate box to indicate your age band:

1. Under 16 / 3. 25-34 years / 5. 45-54 years / 7. 65-74 years
2. 16-24 years / 4. 35-44 years / 6. 55-64 years / 8. 75+ years

Ethnic originPlease tick the appropriate box to indicate your cultural background:

1. White - British / 10. Asian or Asian British - Bangladeshi
2. White – Irish / 11. Any other Asian background
3. Any other white background / 12. Black or Black British - Caribbean
4. Mixed - White and Black Caribbean / 13. Black or Black British - African
5. Mixed - White and Black African / 14. Any other black background
6. Mixed - White and Asian / 15. Chinese
7. Any other mixed background / 16. Prefer not to state
8. Asian or Asian British - Indian / 17. Any other (please write in)
9. Asian or Asian British - Pakistani

Disability

The Disability Discrimination Act 1995 defines a disabled person as anyone with a ‘physical or mental impairment that has a substantial and long-term adverse effect upon his/her ability to carry out normal day-to-day activities’.

Do you consider yourself to have a disability? YesNo

If yes, what is the nature of your disability?Please tick the appropriate box

1. Sensory impairment (including visual and hearing) / 4. Learning disability
2. Physical impairment / 5. Multiple impairments
3. Mental health difficulty (e.g. severe depression, bipolar) / 6. Do not wish to answer

Please provide details of your disability and specify any adjustments we could make to accommodate your needs.

GenderPlease tick the appropriate box to indicate your gender:

1. Male / 3. Transgender
2. Female / 4. Do not wish to disclose

Please describeany issues you have faced in your experience of the British Wheel of Yoga:

Suggested issues

We may wish to contact individuals who have completed this profile form to conduct follow up research on equality issues and barriers.

Please indicate if you are happy to be contacted in the future:

1. Yes / 2. No

Thank you completing this profile form.

Once completed please return by the 30th June2009 to: or by post to: Sport Structures Ltd. PO BOX 3949. Warwick. CV34 9AF

This form contains personal data which will only be processed in accordance with the Data Protection Act 1998.

The form will be opened by a member of Sport Structures Consultancy who have been contracted to support the British Wheel of Yoga with equality work. Your name, email address and contact telephone number are requested so that the consultants can monitor returns and enter you into the prize draw. The British Wheel of Yoga will not have access to individual forms only a composite of results.

We respect a persons rights not to disclose any information requested and therefore completion of this form is not compulsory (please return the blank form with your name).

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