UK Digital Economy Crucible 2017 – Equal Opportunities Form
Submission note:Please submit completed form to by midnight GMT on 5thMarch 2017.
Equal Opportunities Monitoring
UK Digital Economy Crucible aims to support the development of highly promising researchers working in across the UK and is committed to providing equality of opportunity irrespective of applicants’ sex; religious belief; political opinion; race; age; sexual orientation; or whether they are disabled; or whether they are married or are in a civil partnership; or whether they have undergone, are undergoing or intend to undergo gender reassignment.
In support of our commitment to equality of opportunity we monitor applicants according to the categories listed below. Completion of this form (in all or part) is voluntary, but your assistance is appreciated. The information you give will not be used for selection purposes.
Age (as at 5thMarch 2017):
☐16-24
☐25-34
☐35-44
☐45-54
☐55-64
☐65+
Gender
☐Female
☐Male
☐Transgender
☐Prefer not to say
Disability
Do you consider yourself to have a disability?
☐Yes
☐No
If ‘yes’ please specify:
Sexual Orientation
☐Bisexual
☐Heterosexual
☐Gay
☐Lesbian
☐Prefer not to say
Religion or Belief
☐Agnostic
☐Buddhism
☐Christianity
☐Hinduism
☐Islam
☐Jainism
☐Judaism
☐Sikhism
☐No religion
☐Other:Click here to enter text.
☐Prefer not to say
Ethnic Group (categories based on 2001 census and listed alphabetically)
Asian
☐ Asian British
☐ Asian English
☐ Asian Scottish
☐Asian Welsh
☐Bangladeshi
☐Indian
☐Pakistani
☐Chinese
☐Any other Asian background (specify below if you wish)
Click here to enter text.
Black
☐ Black British
☐ Black English
☐ Black Scottish
☐Black Welsh
☐African
☐Caribbean
☐Any other Black background (specify below if you wish)
Click here to enter text.
Mixed
☐White & Asian
☐White & Black
☐African
☐White and Black Caribbean
☐White & Chinese
☐Any other Mixed background (specify below if you wish)
Click here to enter text.
White
☐British
☐English
☐Irish
☐Scottish
☐Welsh
☐Any other White background (specify below if you wish)
Click here to enter text.
☐Prefer not to say
Nationality
Click here to enter text.
Data Protection
Once the assessment process is complete, your application form will be stored for six months and then destroyed. If you are a successful candidate, relevant information may be taken from this form and used as part of your personal UK Digital Economy Crucible record. We may keep your contact details to get in touch with you about other CHERISH-DE project activities you may be interested in. Swansea University is the data controller and all information will be treated as confidential (Data Protection Act, 1998).
☐I consent to the use of information in my form in this way.
UK Digital Economy Crucible - Oct 2016