How Did You First Learn About This Vacancy?

Equality and Diversity Monitoring Form

To ensure that our procedures do not discriminate, and to analyse whether we are attracting applicants and employees from a diverse a range as we are able, we ask everyone to complete a monitoring form.

This form will be separated from your application form and treated in the strictest confidence. Please note that we will not use this information as part of the recruitment selection process. The information you provide will be used for statistical purposes only. It will help us to fulfil our commitment to equal opportunities if you would complete all sections of the form. The information given will be used in compliance with the requirements of the Data Protection Act 1998.

Position applied for:

How did you first learn about this vacancy?

Agency (please specify)
Newspaper or journal (please specify)
Website (please specify which)
Social media (please specify where)
Speculative enquiry
Word of mouth

Eligibility to work in the UK

Are you permitted to work in the UK (tick box)?

Yes
No

(You will be required to provide us with satisfactory evidence that you are entitled to work in the UK)

Criminal Records

Please note below any criminal convictions except those 'spent' under the Rehabilitation of Offenders Act 1974. If none please state. In certain circumstances employment is dependent upon obtaining a satisfactory standard or enhanced disclosure from the Criminal Records Bureau/Scottish Criminal Records Office.

What is your gender identity? (tick box)

Man (including trans man)
Woman (including trans woman)
Other gender identity (androgyne person)

Ethnic origin- To which of these groups do you consider you belong? (please tick relevant box and specify if appropriate)

A White
British
Irish
Any other white background (please specify)
B Mixed
White and black Caribbean
White and black African
White and Asian
Any other mixed background (please specify)
C Asian or Asian British
Indian
Pakistani
Bangladeshi
Any other Asian background (please specify)
D Black or Black British
Caribbean
African
Any other black background (please specify)
E Chinese or other ethnic group
Chinese
Any other (please specify)

How would you describe your religion or religious beliefs?(please tick relevant box and specify if appropriate)

Buddhist
Christian
Hindu
Jewish
Muslim
Sikh
No religion
Other (please specify)

What is your age?(please tick relevant box)

Under 18

18 – 24

25 – 34

35 – 44

45 – 54

55 – 64

65 and over

Marital status(please tick relevant box)

Married/Civil Partnership
Single
Separated
Divorced
Living with partner
Widowed
Prefer not to say

How would you describe your sexual orientation?Please tick box

Bisexual
Gay man
Gay woman/lesbian
Heterosexual/Straight
Other, please write in
Prefer not to say

Do you consider yourself to have a disability?

NB. The Disability Discrimination Act (1995) covers any individual who has a physical or mental impairment, which has substantial long-term adverse affect on his or her ability to carry out normal day to day activities. You do not need to be registered disabled to be covered by the Act.

Yes
No