Application Form
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Last Name
Address
Street Address
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Email
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Equal Opportunities Monitoring
We are an equal opportunity employer. The aim of our policy is to ensure that no job applicant or employee receives less favourable treatment because of age, disability, gender reassignment, marriage and civil partnership, pregnancy or maternity, race, religion or belief, sex or sexual orientation. Our recruitment selection criteria and procedures (including the areas or media sources which are used in the recruitment process) are frequently reviewed to ensure that individuals are selected, promoted and treated on the basis of their relevant merits and abilities and that no applicant or employee is disadvantaged by provisions ,criteria or practices which cannot be shown to be justified. We would like to use your data to ensure that this policy is fully and fairly implemented. We will use your data to compile statistics on the representation amongst our workforce of the categories listed. To use this information, we need your consent. Signing in the space below will indicate that you consent to your data being used for the purposes stated. You may withdraw your consent at any time by contacting (Emma Povey, HR Lead).Completion of this form is optional. Any responses you give will assist us in our commitment to equality, diversity and inclusion in the workplace. Your responses will be kept strictly confidential and will not be used in any decisions affecting you.
Which of the following best describes your gender?
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Male
Female
Prefer to self describe
Prefer not to say
Is the gender you identify with the same as the gender you were registered with at birth?
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YES
NO
Prefer not to say
Age Range
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16 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 60
60+
What is your ethnicity?
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Indian
Pakistani
Bangladeshi
Chinese
African
Caribbean
White & Black Caribbean
White & Black African
White & Asian
English
Welsh
Scottish
Northern Irish
Irish
British
Gypsy or Irish Traveller
Prefer not to say
Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong.
Do you consider yourself to have a disability or health condition (visible or not) including Neurodiversity?
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YES
NO
Prefer not to say
What is the effect or impact of your disability or health condition on your work?
Which of the following best describes your sexual orientation?
Please Select
Heterosexual
Gay
Lesbian
Bisexual
Prefer not to say
What is your religion or belief?
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No religion or belief
Buddhist
Christian
Hindu
Jewish
Muslim
Sikh
Prefer not to say
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