Equal Opportunities Monitoring Form Question Title * 1. What is the job title of the role applied for? Question Title * 2. What is your full name? Question Title * 3. What is your gender? Female Male Other (please specify) Question Title * 4. What is your age? 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 or older Question Title * 5. What is your religion (Please select all that apply.) Protestant Catholic Christian Judaism Muslim Sikh Hindu Buddhist No religion Other (please specify) Question Title * 6. What is your ethnic background? (Please select all that apply.) White British White Irish White Other Black British Black Caribbean Black African Mixed White and Black Caribbean White and Black Asian White and Black African Other Mixed Asian British Indian Pakistani Bangladeshi Other Asian Chinese Other Other (please specify) Question Title * 7. Do you consider yourself to have an impairment or to be disabled as defined by the 1995 Disability Discrimination Act, carried forward into the Equality Act 2010? Yes No Question Title * 8. Where did you see this vacancy advertised? The Fostering Network Website Charity Jobs Guardian Jobs Online Third Sector Recruit 3 The Belfast Telegraph NI Job Finder Facebook Twitter Other (please specify) Done
