Equal Opportunities Monitoring Form
You are requested to complete this form to help us to ensure that all job applicants are treated equally, without discrimination on the grounds of gender, sexual orientation, marital or civil partner status, gender reassignment, race, colour, nationality, ethnic or national origin, religion or belief, disability or age. This form is stored separately from your application and is not used for the purpose of recruitment decisions. If you are invited for interview, the information you have supplied on the form will not be viewed by the interviewing panel. It is strictly used for monitoring purposes only.
Title of post applied for?
What is your gender?
Please Select
Female
Male
Prefer not to say
If you are undergoing gender reassignment, please use the gender identity you intend to acquire.
Do you identify as transgender/transsexual?
Please Select
Yes
No
Prefer not to say
What is your age?
Please Select
16-17
18-21
22-30
31-40
41-50
51-60
61-65
66-70
71+
Prefer not to say
How would you describe your nationality and/or ethnicity?
Please Select
British – English, Scottish or Welsh
Irish
Other White background
White and Black Caribbean
White and Black African
White and Asian
Other mixed background
Indian
Pakistani
Bangladeshi
Other Asian background
Caribbean
African
Other Black background
Chinese
Other ethnic group
Prefer not to say
Which of the following best describes your sexual orientation?
Please Select
Heterosexual
Bisexual
Gay man
Gay woman/lesbian
Prefer not to say
I would describe my religion or belief as:
I have no particular religion or belief
Prefer not to say
Other
Do you consider that you have a disability under the Equality Act?
Please Select
Yes
No
Don't know
Prefer not to say
The Equality Act 2010 defines a disability as a ‘physical or mental impairment which has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to day activities’. An effect is long term if it has lasted or is likely to last more than 12 months.
If you have a disability that means you may need particular help in order to attend and/or participate in any part of the selection process, please give details in the box below:
Submit
Should be Empty: