First name: Last name: Age: –None– 18 – 24 years old 25 – 34 years old 35 – 44 years old 45 – 54 years old 55 – 64 years old 65 years or older Prefer not to say Gender: –None–Woman Man Non-binary Prefer not to say Email: Phone: Address in Edinburgh (building number, street and postcode): Which part of Edinburgh do you live in? –None–Central Edinburgh (EH1, EH2, EH3) West Edinburgh (EH4) North East Edinburgh & Leith (EH5, EH6, EH7, EH15) South Edinburgh (EH8, EH9, EH10, EH16, EH17) South West Edinburgh (EH11, EH12, EH13, EH14) Edinburgh Postal District (EH18 to EH55) Outside of Edinburgh What is your Nationality? –None–Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Central African Republic (CAR) Chad Chile China Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Costa Rica Cote d’Ivoire Croatia Cuba Cyprus Czechia Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (formerly Swaziland) Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar (formerly Burma) Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria North Korea North Macedonia (formerly Macedonia) Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea South Sudan Spain Sri Lanka Sudan Suriname Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates (UAE) United Kingdom (UK) United States of America (USA) Uruguay Uzbekistan Vanuatu Vatican City (Holy See) Venezuela Vietnam Yemen Zambia Zimbabwe What is your first language? –None–Arabic Armenian Bengali Bulgarian Czech Dari Farsi French Greek Hindi Italian Japanese Kurdish Mandarin Pashto Polish Portuguese Romanian Russian Spanish Turkish Ukrainian Urdu Other(Please type your language below) If your language doesn’t appear on the list above please type it here: Do you have a disability? –None– No Yes Prefer not to say What is your ethnic group or background? –None–White – Scottish White – Other British White – Irish White – Gypsy Traveller White – Polish White – Roma White – Showman/Showwoman Other White Ethnic Group African, African Scottish or African British Asian – Pakistani, Pakistani Scottish or Pakistani British Asian – Indian, Indian Scottish or Indian British Asian – Bangladeshi, Bangladeshi Scottish or Bangladeshi British Asian – Chinese, Chinese Scottish or Chinese British Any Other Asian Caribbean or Black, Caribbean or Black Scottish, Caribbean or Black British Any Mixed or Multiple Ethnic Groups Arab, Arab Scottish or Arab British Any Other Ethnic Group Prefer not to say What is your religion or belief? –None–No Religion or Belief Church of Scotland Roman Catholic Other Christian Muslim Hindu Buddhist Sikh Jewish Pagan Any other religion Prefer not to say What is your current employment status? –None–Working Not working & looking for a job Not working & not looking for a job A student Retired Other When did you come to Edinburgh? When did you come to the UK? What is your immigration status?* –None–Refugee Asylum seeker EU Citizen: pre-settled status EU Citizen: settled status British Citizen Other Prefer not to say *We require this information as part of our funding criteria to ensure we are offering equal access to our services across the New Scots and migrant community. This information is confidential to The Welcoming team and not shared with third parties. What services are you most interested in? (Please select as many as you like, for more information click here.) ESOL – English Classes Conversation Groups Friendship Programme Employment Support Women’s Groups Career Advice or Skills Development Cultural outings and events Health and Wellbeing Home Energy Advice Community Fridge How would you describe your current level of English? –None–Complete Beginner Beginner Elementary Intermediate Upper-Intermediate Advanced How did you find out about The Welcoming? Website www.thewelcoming.org Facebook Google Instagram Twitter Friends/family Job Centre Citizens Advice Bureau Council website www.joininedinburgh.org Saw a poster/flyer in a cafe/hostel/community centre etc. Referral from outside organisation[Please type the name below] What organisation told you about The Welcoming? Have you registered with us before? Yes No If you have registered with us before, what is your old registration number? * We will store your information securely and will not share your personal details with third parties under any circumstances. Please see our Privacy Notice page on our website. By submitting this form you are consenting for us to hold the information you have provided in this form. If you wish for us to stop holding this information then please get in touch, you can withdraw your consent anytime and ask us to stop holding your information by emailing us at [email protected]. We collect your details to assess your eligibility for the services we offer and for the purposes set out in our Data Protection Policy. We may need to contact you for further information to support your registration as a service user. We will retain your information for monitoring, analysis and targeting, and may contact you, by letter, email and telephone, in the future to get your feedback on our services.
