Lewisham Ethnic Background Record Form

[based on the new national population census ethnic categories]

 

 

Pupil’s Name ……………………………………………………………..

 

Class/Form ………………………………………………………………..

 

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 or 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 pupil 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/Roma                                                
Any other White background                                                
                                      o   Turkish/Turkish Cypriot                                                
                                      o   White European                                                

 

Mixed

White & Black Caribbean                                                
White and Black African                                                
White and Asian                                                
Any other mixed background                                                

 

Asian or Asian British

Indian                                                
Pakistani                                                
Bangladeshi                                                
 Any other Asian background                                                
                                                    o   Sri Lankan Tamil                                                

 

 

 

Black or Black British

Caribbean                                                
African                                                
                                               o   Somali                                                
                                               o   Other Black African                                                
Any other Black background                                                

 

Chinese

Chinese                                                

 

Any other ethnic background

Any other ethnic background                                                
                                                         o   Vietnamese                                                

 

I do not wish an ethnic background category to be recorded                                                

 

 

 

 

This information was provided by:

 

Parent/Carer

 

Pupil