Equal Opportunity Monitoring Form

Equality Opportunities Monitoring Form
The Roses Theatre wants to meet the aims and commitments set out in our equality policy. This includes not discriminating under the Equality Act 2010.

Please complete this form to help us understand the diversity of our job applicants and workforce.

Completing this form is voluntary. The information provided will be kept confidential. The information is going to be used to help us understand the diversity of our organisation.

If you are applying for a job, none of the information you provide will be linked to your application.

If you have any questions about the form contact georgia.shire@rosestheatre.org
Role
What is the title of the job that you have applied for?
Age
What is your age?

19 or under20 - 2930 - 3940 - 4950 - 5960 - 6970+Prefer not to answer
Disability
Do you have a disability, impairment or health condition which affects your day-to-day activities?

YesNoPrefer not to say
Sex and Gender
Sex

MaleFemalePrefer not to answerOther
Is the gender you identify with the same as your assigned sex at birth?

YesNoPrefer not to answer
Sexual Orientation
What is your sexual orientation?

HeterosexualGayLesbianBisexualAsexualPansexualPrefer not to answerOther
Marital Status

MarriedCivil PartnershipDivorcedSingleCo-habitingSeparatedWidowedPrefer not to answerOther
Ethnicity

This may be different to your nationality, place of birth or citizenship.
Asian/Asian British

IndianPakistaniBangladeshiChineseArabPrefer not to answerNone of the aboveOther
Black/African/Caribbean/Black British

AfricanCaribbeanPrefer not to answerNone of the aboveOther
Mixed/Multiple ethnic groups

White and Black CaribbeanWhite and Black AfricanWhite and AsianPrefer not to answerNone of the aboveOther
White

EnglishWelshScottishNorthern IrishIrishGypsy or Irish TravellerPrefer not to answerNone of the aboveOther
My Nationality is:
Please leave blank if you prefer not to answer.
Religion or belief
What is your religion or belief?

No religion or beliefBuddhistChristianHinduJewishMuslimSikhPrefer not to answerOther
Should be Empty:

Equality Opportunities Monitoring Form

Role

Age

Disability

Sex and Gender

Sexual Orientation

Ethnicity

Religion or belief