BRISTOL OLDVIC

EQUALITY, DIVERSITY and INCLUSION MONITORING FORM
Bristol Old Vic is committed to ensuring that all applicants and employees are treated equally and without discrimination because of; age, disability, gender reassignment, marriage or civil partnership, pregnancy and maternity, race, religion/belief, sex (gender) and sexual orientation. This form is intended to help us maintain equal opportunities, best practice, and identify barriers to workforce equality and diversity.

We're on a journey to build a workforce that is fully reflective of Bristol's population, and we particularly welcome applicants and employees who have previously been under-represented at Bristol Old Vic and in the theatre sector at large, due to the experience of barriers linked to ethnicity, class, disability, gender, geography, sexuality, age and religion.

Submission of this form indicates your explicit consent that your data may be processed in accordance with the provisions of the General Data Protection Regulation 2018 and the Theatre's Data Protection Policy.
Name*

First NameLast Name
Position applied for*
Ethnicity Monitoring
Please tick the categories that apply below: These classifications are those recommended by the Commission for Racial Equality.

Note: Ethnic origin questions are not necessarily about nationality, place of birth or citizenship; they are about colour, culture, and ethnic groups; and citizens of any country may belong to any of the groups indicated.
Black or Black British:

AfricanCaribbeanAny other Black, Black British, or Caribbean background
Mixed or multiple ethnic groups:

White and Black CaribbeanWhite and Black AfricanWhite and AsianAny other Mixed or multiple ethnic background
Other ethnic group:

ArabLatin AmericanAny other ethnic group
White:

British (English, Welsh, Scottish, Northern Irish)IrishGypsy or Irish TravellerRomaAny other White background
Not known/Prefer not to say
Please tick the categories that apply below:
Age Monitoring:*

16-1718-2122-3031-4041-5051-6061-6566-7071+
Legal Gender- What is your legal gender?:*

FemaleMalePrefer not to say
I prefer to self-describe
Gender Identity- What is your gender idenity?:*

FemaleMaleNon- binaryTransgender ManTransgender WomanPrefer not to say
I prefer to self-describe
Sexual Orientation- How do you identify yourself?:*

Heterosexual/StraightBi-sexualGay Man/HomosexualGay Woman/LesbianPansexualAsexualQueerPrefer not to say
I prefer to self-describe
Religious Belief:*

ChristianMuslimJewishSikhHinduBuddhistSpiritualAtheistAgnosticPrefer not to say
Other religion/ belief (please specify)
Disability Monitoring

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.
Under this definition, would you say you have a disability?*

YesNo
If you have answered Yes, please tick the categories that apply below:

Visual ImpairmentPhysical disabilitiesHard of Hearing/deafCognitive or learning disabilitiesOther long term/chronic conditionNot known/Prefer not to say
Neurodiversity Awareness

Neurodivergence refers to cognitive differences that deviate from what is considered ‘neurotypical’, or traditional, ways of processing information.
Under this definition, would you say you have a Neurodivergent condition?*

YesNo
If you have answered Yes, please tick the categories that apply below:

Autism Spectrum Disorder (ASD)Attention Deficit Hyperactivity Disorder (ADHD)DyslexiaDyscalculiaDyspraxiaTourette SyndromeDown Syndrome
Caring responsibilities

A carer is defined as someone who, without pay, looks after and provides help and support to a partner, child (17 or under) or relative who could not manage without their help or support. This caring responsibility could be necessary due to age, physical or mental illness, addiction, sickness or disability. We will use this information to inform our flexible working practices.
Under this definition, would you say you have caring responsibilities?*

YesNo
If you have answered Yes, please tick the categories that apply below:

Childcare Responsibilities (daily drop off/ pick up etc.)Care for a child with physical or mental impairment/illnessCare for a relative who lives with meCare for a relative who does not live with meCare for my partnerOther
Socio-Economic Background

The following question captures data related to socio-economic background based on guidance developed by Jerwood Arts and the Bridge Group in accordance with the National Statistics Socio-Economic Classification (NS-SEC) scheme.
Thinking back to when you were 14, which type of work best describes the main/highest income earner in your household and their main job?
Please tick the category that applies below:*

Modern Professional Occupations: E.g. Teacher/lecturer, nurse, physiotherapist, social worker, welfare officer, actor, artist, musician, police officer (sergeant or above), software designerClerical and Intermediate Occupations: E.g. secretary, personal assistant, clerical worker, office clerk, call centre agent, nursing auxiliary, nursery nurseSenior Managers and Administrators: Usually responsible for planning, organising and co-ordinating work for finance such as finance manages, chief executive etcTechnical and Craft Occupations: E.g. motor mechanic, fitter, inspector, plumber, printer, tool maker, electrician, gardener, train driverSemi-Routine Manual and Service Occupations: E.g. postal worker, machine operative, security guard, caretaker, farm worker, catering assistant, receptionist, sales assistantRoutine Manual and Service Occupations: E.g. HGV driver, van driver, cleaner, porter, packer, sewing machinist, messenger, labourer, waiter/waitress, bar staffMiddle or Junior Managers: E.g. office manager, retail manager, bank manager, restaurant manager, warehouse manager, publicanTraditional Professional Occupations: E.g. solicitor, accountant, medical practitioner, scientist, civil/mechanical engineerSelf-employedShort Term Unemployed: Claimed Jobseeker’s Allowance or earlier unemployment benefit for a year or lessLong Term Unemployed: Claimed Jobseeker’s Allowance or earlier unemployment benefit for more than a yearRetiredDon’t KnowNot ApplicablePrefer not to sayOther
Should be Empty:

EQUALITY, DIVERSITY and INCLUSION MONITORING FORM

Ethnicity Monitoring

Please tick the categories that apply below:

Disability Monitoring

Neurodiversity Awareness

Caring responsibilities

Socio-Economic Background