Equal Opportunities Monitoring Information

Equal Opportunities Monitoring Information

In accordance with Alzheimer’s Society’s equal opportunities policy, new employees are selected on job-related criteria only: the ability to meet the criteria of the job as outlined in the person specification. The questions below help the Society monitor the effectiveness of its equal opportunities policy. The information you supply on this form will be used for statistical purposes only. Please therefore complete all questions by ticking the appropriate box or entering the information requested.

Please return this form to , or

HR Service Centre, Alzheimer’s Society, Devon House, 58 St Katharine’s Way, London, E1W 1LB.

Please send your application form separatelyto the email or address stated in the job information pack.

Role details / Position applied for:
Location of role: / Closing date:
Personal Details / Gender: / Female Male / Age:
Are you currently working or volunteering for Alzheimer’s Society? / Yes / No
For employment purposes*, do you consider yourself disabled? / Yes / No

*For employment purposes, a disabled person is defined as a person with a physical or mental impairment which has a substantial and long term adverse effect on his or her ability to carry out normal day-to-day activities.

How did you hear about this vacancy? Please tick one option, specifying which newspaper/website if appropriate.

Alzheimer’s Society website / Advert in newspaper (please specify below)
Job Centre / Advert online (please specify below)
Friend/relative/colleague / Employment Agency (please specify below)
Other (please specify)

Website

Registered charity no 296645. A company limited by guarantee and registered in England no 2115499.

Please indicate how you prefer to describe your ethnic group. Please tick one option.

The categories below are based on the current Office for National Statistics suggested ethnicgroupings.

WhiteMixed/Multiple Ethnic Groups

English / Welsh / Scottish / Northern Irish / British
Irish
Gypsy or Irish Traveller
Any other White background (please specify) / White and Black Caribbean
White and Black African
White and Asian
Any other mixed background (please specify)

Black/African/Caribbean/Black BritishAsian/Asian British

Caribbean
African
Any other Black background (please specify) / Indian
Pakistani
Bangladeshi
Chinese
Any other Asian background (please specify)

Other Ethnic Group

Arab / Any other ethnic background (please specify)
Please specify if appropriate:

Website

Registered charity no 296645. A company limited by guarantee and registered in England no 2115499.