Applicant Equal Opportunities Monitoring Form

This form is completely anonymous and will not be included as part of the short listing process. All provided information will be used for recruitment monitoring and provision of statistical data purpose only.

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* 1. Position Applied for

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* 2. Where did you see this post advertised?

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* 3. Location of post

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* 4. Sex

Female

Male

Prefer not to say

Prefer to self-describe:

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* 5. Have you ever identified as transgender?

Yes

Prefer not to say

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* 6. Which age band are you in?

18-24

25-34

35-44

45-54

55-64

65+

Prefer not to say

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* 7. Sexual orientation

Heterosexual/straight

Gay man

Gay woman / Lesbian

Bi-sexual

Other

Prefer not to say

Prefer to self-describe:

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* 8. Do you consider yourself to have a disability or long-term health condition?

Yes

Prefer not to say

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* 9. Ethnicity?

White - English/Welsh/Scottish/Northern Irish/British

White - Irish

White - Gypsy or Irish Traveller

White - other White background

Mixed/multiple ethnic groups - White and Black Caribbean

Mixed/multiple ethnic groups - White and Black African

Mixed/multiple ethnic groups - White and Asian

Other Mixed/multiple ethnic background

Asian/Asian British - Indian

Asian/Asian British - Pakistani

Asian/Asian British - Bangladeshi

Asian/Asian British - Chinese

Other Asian background

Black/African/Caribbean/Black British - African

Black/African/Caribbean/Black British - Caribbean

Other Black/African/Caribbean background

Other ethnic group - Arab

Any other ethnic group

Prefer not to say

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* 10. What is your religion or belief?

Buddhist

Christian

Hindu

Jewish

Muslim

Sikh

No religion

Prefer not to say

Other (please specify)

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* 11. Are you a UK Citizen?

Yes

Other (please specify)

Thank you for your time answering the questions. Please press done to submit your responses.