Men in Childcare Application - Fife
Fife College (Halbeath Campus), Pittsburgh Road, Dunfermline KY11 8DY
Equal Opportunities Monitoring Form
All information on this form is confidential to Men in Childcare
Confirm college being applied for (tick box)
Fife College, Pittsburgh Road, Dunfermline KY11 8DY
Forename(s)
Surname
Address
Postcode
Tel. No
E- mail
Confirm e-mail
Age
1. What is your current situation?
current situation
In full time employment
In part time employment
Not working (registered unemployed)
Not working (not registered unemployed)
Other (please specify below)
. . . specify
Are you in receipt of benefit? (Yes/No)
Please specify which benefits you receive
How long have you been in receipt of benefit?
2. If not working, how long have you been out of work?
how long?
Less than 6 months
6-12months
12-24 months
24+months (if so, how long?) specify below
. . . specify
3. What is the highest level of qualification that you hold?
highest qualification
None
S/O Grades
Highers
CSYS NC
HNC
HND
st Degree
Higher Degree Modules/Units
GN/SVQ
N/SVQ
Other
4. Do you have a disability that could affect your participation on the course?
disability
yes
no
If yes, please tell us about any arrangements we can make to enable you to participate fully:
5. How would you describe your ethnic origin?
ethnic origin
White
Black Caribbean
Black African
Black Other
Indian
Pakistani
Bangladeshi
Chinese
Other (specify below)
. . . specify
6. How did you hear about this initiative?
how did you hear
Word of mouth
Leaflet
Newspaper
Poster
Other organisation (specify below)
. . . specify
Date
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