Diversity Survey HR

DIVERSITY SURVEY

Name (Optional): 

Employee ID (Optional): [0909-099]

Department: HR


Instructions for Survey Participants: Please complete this survey voluntarily by selecting applicable demographic choices, or use "Prefer not to say" if uncomfortable disclosing. You may also share additional comments if desired. Your participation contributes to our commitment to diversity and inclusion.

Thank you for your input.

Gender: 

  • Male

  • Female

  • Non-Binary

  • Prefer not to say

  • Other (please specify): 

Age:

  • Under 18

  • 18-24

  • 25-34

  • 35-44

  • 45-54

  • 55-64

  • 65 or over

  • Prefer not to say

Race/Ethnicity (Select all that apply)

  • White/Caucasian

  • Black/African American

  • Hispanic/Latinx

  • Asian

  • Native American

  • Native Hawaiian

  • Two or more races

  • Other (please specify): 

Sexual Orientation

  • Straight

  • Lesbian

  • Gay

  • Bisexual

  • Pansexual

  • Asexual

Prefer not to say

Disability Status

I do not have a disability

I have a physical disability

I have a sensory disability

I have a cognitive or learning disability

I have a mental health condition

I prefer not to disclose

Prefer not to say

Veteran Status

  • I am a veteran

  • I am not a veteran

  • Prefer not to say


Additional Comments (Optional)

Please feel free to provide any additional comments or suggestions related to diversity and inclusion in the workplace. Your input is valuable to us.




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