Data Collection Form (Epd2) printable pdf download

Data Collection Form (Epd2)

(EPD2)

ATA

OLLECTION

ORM

Pupil’s name: ______________________________________________ Class: ___________

THNICITY

Our ethnic background describes how we think of ourselves. This may be based on many things, including, for example, our

skin colour, language, culture, ancestry or family history. Ethnic background is not the same as nationality or country of birth.

The Information Commissioner (formerly the Data Protection Registrar) recommends that young people aged over 11 years old

have the opportunity to decide their own ethnic identity. Parents of those with parental responsibility are asked to support or

advise those children aged over 11 in making this decision, wherever necessary. Pupils aged 16 or over can make this decision

for themselves.

Please study the list below and tick one box only to indicate the ethnic background of the pupils or child named above. Please

also tick whether the form was filled in by a parent or the pupil.

White

[ ]British

[ ]Irish

[ ]Traveller of Irish Heritage

[ ]Gypsy/Romany

[ ]Any other White background

Mixed

[ ] White and Black Caribbean

[ ] White and Black African

[ ] White and Asian

[ ] Any other mixed background

Asian or Asian British

[ ] Indian

[ ] Pakistani

[ ] Bangladeshi

[ ] Any other Asian background

Black or Black British

[ ] Caribbean

[ ] African

[ ] Any other Black background

[ ] Chinese

[ ] Any other ethnic background

[ ] I do not wish an ethnic background category to be recorded

This information was provided by:

Parent

[ ]

Pupil

[ ]

Data Collection Form (Epd2)