Carterwood equality and diversity monitoring form

Carterwood is committed to meeting the aims and commitments set out in its equality and diversity policy. This includes not discriminating under the Equality Act 2010, and building an accurate picture of the makeup of our workforce in encouraging equality and diversity. We need your help in order to do this but filling in this form is voluntary.

Your answers are anonymous and strictly confidential and will be used for monitoring purposes.

The form will be separated from your application and will NOT play any part in the recruitment process.

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* 1. Please identify which age group you belong to

16-24

25-34

35-44

45-54

55-64

65+

Prefer not to say

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* 2. What is your gender?

Male

Female

Non-binary

Intersex

Other

Prefer not to say

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* 3. Do you consider yourself to have a disability, impairment, learning difference or long term condition?

The Equality Act 2010 defines disability as ‘a physical or mental impairment which has a substantial & long-term effect on a person’s ability to carry out normal day to day activities.

Yes

Prefer not to say

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* 4. If yes, what best describes your disability, impairment, learning difference or long term condition?

A specific learning difference such as dyslexia, dyspraxia or AD(H)D

General learning disability (such as Down's syndrome)

A social/communication impairment such as Asperger's syndrome/other autistic spectrum disorder

A long-standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease or epilepsy

A mental health condition, such as depression, schizophrenia or anxiety disorder

A physical impairment or mobility issues, such as difficulty using arms or using a wheelchair or crutches

Deafness or serious hearing impairment

Blindness or a serious visual impairment uncorrected by glasses

A disability, impairment, learning difference or long-term condition that is not listed above

Prefer not to say

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* 5. What is your ethnicity?

Ethnic origin categories are not about nationality, birthplace or citizenship. They are about the group to whom you see yourself as belonging to. Please indicate your ethnic origin by selecting the appropriate box.

White: British

White: English

White: Welsh

White: Northern Irish

White: Scottish

White: Irish

White: Gypsy or Irish Traveller

White: Any other White background

Mixed: White & Black Caribbean

Mixed: White & Black African

Mixed: White & Asian

Mixed: Any other background

Black, African, Caribbean or Black British: Caribbean

Black, African, Caribbean or Black British: African

Black, African, Caribbean or Black British: Any other background

Asian or Asian British: Indian

Asian or Asian British: Pakistani

Asian or Asian British: Bangladeshi

Asian or Asian British: Chinese

Asian or Asian British: Other

Other Ethnic Group: Arab

Other Ethnic Group: Any other background

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* 6. Religion or belief

Christian

Buddhist

Hindu

Jewish

Sikh

Muslim

No religion

Other

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* 7. Sexual orientation

Heterosexual

Gay

Lesbian

Bisexual

Asexual

Pansexual

Undecided

Prefer not to say

Other

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* 8. Do you have caring responsibilities, please tick all that apply.

None

Primary carer of child / children under 18

Primary carer of disabled child / children

Primary carer of disabled adult (over 18)

Primary carer of older person

Secondary carer (another carer carries out the primary role)

Prefer not to say

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* 9. What is your highest level of academic attainment?

GCSE grades D-G or 3-1, NVQ 1 or equivalent

GCSE grades A-C or 9-4, NVQ 2, or equivalent

A levels, BTEC, NVQ 3 or equivalent

Degree level or equivalent

Post graduate qualification ie Masters, MBA

Carterwood equality and diversity monitoring form

Question Title

* 1. Please identify which age group you belong to

Question Title

* 2. What is your gender?

Question Title

* 3. Do you consider yourself to have a disability, impairment, learning difference or long term condition?The Equality Act 2010 defines disability as ‘a physical or mental impairment which has a substantial & long-term effect on a person’s ability to carry out normal day to day activities.

Question Title

* 4. If yes, what best describes your disability, impairment, learning difference or long term condition?

Question Title

* 5. What is your ethnicity?Ethnic origin categories are not about nationality, birthplace or citizenship. They are about the group to whom you see yourself as belonging to. Please indicate your ethnic origin by selecting the appropriate box.

Question Title

* 6. Religion or belief

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* 7. Sexual orientation

Question Title

* 8. Do you have caring responsibilities, please tick all that apply.

Question Title

* 9. What is your highest level of academic attainment?

* 3. Do you consider yourself to have a disability, impairment, learning difference or long term condition?

The Equality Act 2010 defines disability as ‘a physical or mental impairment which has a substantial & long-term effect on a person’s ability to carry out normal day to day activities.

* 5. What is your ethnicity?

Ethnic origin categories are not about nationality, birthplace or citizenship. They are about the group to whom you see yourself as belonging to. Please indicate your ethnic origin by selecting the appropriate box.