Choose one section from A to E, then [check] the appropriate box to indicate your cultural background.

A White

[] British
[] Irish
[] Any other White background, please write in ________

B Mixed

[] White and Black Caribbean
[] White and Black African
[] White and Asian
[] Any other Mixed background, please write in ________

C Asian or Asian British

[] Indian
[] Pakistani
[] Bangladeshi
[] Any other Asian background, please write in ________

D Black or Black British

[] Caribbean
[] African
[] Any other Black background, please write in ________

E Chinese or other ethnic group

[] Chinese