Equal Opportunities Monitoring Form
This section is not part of your application form, and is only for our records. You are not obliged to answer any of these questions but we encourage you to do so in order for us to achieve best practice in recruitment.
Position applied for:
1. How would you describe your gender?
I would describe my gender as: / ......Prefer not to say /
If you are undergoing gender reassignment, use the gender identity you intend to acquire.
2. Choose one of the groups below to indicate your ethnic group (tick one box only)
- White
English/Welsh/Scottish/Northern Irish/British Irish
Gypsy or Irish TravellerAny other white background
- Mixed/multiple ethnic groups
White & Black CaribbeanWhite & Black African
White & AsianAny other Mixed/multiple ethnic background
- Asian/Asian British
Asian IndianAsian Pakistani
Asian BangladeshiChinese
Any other Asian background
- Black/African/Caribbean/Black British
Black AfricanBlack Caribbean
Any other Black background
- Other ethnic group
ArabAny other ethnic group
3. Do you consider yourself to have a disability as described in The Equality Act 2010?
The Equality Act protects people with a disability who have ‘a physical or mental impairment, which has a substantial long-term adverse effect on [their] ability to carry out normal day-to-day activities. Long term means 12 months or more.
Yes / / No /Used to have a disability but have now recovered / / Don't know /
Prefer not to say /
4. What is your age?
Under 2525-3435-44.45-54.55-6465+
5. How would you describe your religion or other strongly-held belief?
I would describe my religion or belief as: / ......I have no particular religion or belief /
Prefer not to say /
6.How would you describe your sexual orientation?
Heterosexual / / Bisexual / / Prefer not to say /Gay Man / / Lesbian / / Other /
7. Did you mainly attend a state or fee paying school between the ages of 11 – 18?
State Fee paying
8. Did either of or both of your parents obtain a degree from a higher education establishment?
YesNo
9. If you have children under 17 in your household, would you say that you, or someone else, takes main responsibility for providing/organising child care?
MeSomeone else
No children / not applicableShared Equally
How did you hear about the vacancy?
Thank You for taking the effort to complete this Equal Opportunities monitoring form.