Lime Pictures Equality Monitoring form for candidates

1. Equality Monitoring Survey

Lime Pictures Ltd is committed to creating a diverse and inclusive workplace and ensuring that everyone who works with us is treated fairly and equally. To help us ensure we are attracting, developing and retaining a workforce that is as diverse and inclusive as the content we produce and distribute, we collect equal opportunity data. The data you provide will help us to develop appropriate policies and procedures regarding equal opportunities and will not be used as part of our selection processes, or shared with hiring managers.
This information will be treated in the strictest confidence and only accessible by the HR department. It will be processed under relevant Data Protection legislation. You are not obliged to complete this form or answer every question, but we encourage you to do so and provide as much information as you are comfortable to.

By completing this form you confirm your understanding that Lime Pictures Ltd will process the information you provide in accordance with the relevant privacy notice.

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* 1. What is your name?

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* 2. What job role are you applying for?

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* 3. What is your gender?

Male

Female

Intersex

Non-binary

Prefer not to say

If you prefer to use your own term, please specify here.

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* 4. Gender identity: Is your gender identity the same as at birth?

Yes

Prefer not to say

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* 5. Are you married or in a civil partnership?

Yes

Prefer not to say

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* 6. How would you describe your sexual orientation?

Bisexual

Lesbian

Gay man

Heterosexual/ Straight

Prefer not to say

Other (please specify)

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* 7. What is your age?

16-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75+

Prefer not to say

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* 8. How would you describe your ethnic origin? Please tick the heading in bold and sub heading below it that applies to you.

Black/African/Caribbean or Black British (please also tick the option below that applies to you)

African

Caribbean

Any other Black, African or Caribbean background, please specify below

Mixed or Multiple Ethnic Background (tick the option below that applies to you)

White and Asian

White and Black African

White and Black Caribbean

Any other mixed ethnic background, please specify below

East Asian or East Asian British (Including SE Asian or SE Asian British) (tick the option below that applies to you)

Chinese

Any other East Asian background (please specify below)

White (tick the option below that applies to you)

British

English

Welsh

Scottish

Northern Irish

Central and Eastern European

Gypsy or Irish Traveller

Irish

Other White background, please specify below

Any other ethnic background (tick the option below that applies to you)

Arab

Any other ethnic background, please specify below

If you ticked any of the other options above please specify here

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* 9. Disability is defined under The Equality Act 2010 as “a physical or mental impairment, which has a substantial and long-term adverse effect on a person’s ability to carry out normal day to day activities”. An effect is long-term if it has lasted, or is likely to last, for at least 12 months, or is likely to last for the rest of the person's life.

Within the definition of the Equality Act, do you consider you have a disability?

Yes

No (go straight to Question 10)

Prefer not to say

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* 10. Disability: If you answered yes to Q8, what best describes your disability, impairment, learning difference or long-term condition? Tick all that apply.

Blind or a serious visual impairment uncorrected by glasses

Deaf or serious hearing impairment

General learning disability (such as Down's Syndrome)

Long-standing illness or health condition, such as depression, schizophrenia or anxiety disorder

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

Two or more impairments and/or long-term conditions

A disability, impairment, or long-term condition that is not listed above (including a hidden disability not listed above)

Prefer not to say

Prefer to self-describe

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* 11. Do you consider yourself to be neurodiverse?

No (go to question 11)

Yes (please tick all that apply below)

Attention Deficit (Hyperactive) Disorder (AD(H)D)

Autistic Spectrum Disorder (ASD)

Dyslexia

Dyscalculia

Dyspraxia

Obsessive Compulsive Disorder (OCD)

Prefer not to say

Another form of neurodiversity (e.g. Tourette's Syndrome). Or prefer to self-describe. Please specify:

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* 12. Religion/belief

I have no religion or belief

Buddhist

Christian

Hindu

Jewish

Muslim

Sikh

Prefer not to say

Other, I would describe my religion or belief as:

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* 13. Do you have caring responsibilities? If yes, tick all that apply

None

Primary carer of a child/children (under 18)

Primary carer of an older person

Primary carer of a disabled child/children

Primary carer of a disabled adult (18 and over)

Secondary carer (another person carries out the main caring role)

Prefer not to say

Prefer to self-describe:

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* 14. When you were 14, what did the main income earner in your household do for a living? What was their main job? If this question does not apply to you (for instance, if you were in care), you can indicate this below.

Clerical/intermediate occupations e.g. secretary, personal assistant, nursery nurse, office clerk, call-centre agent

Middle or junior manager e.g. office manager, warehouse manager, restaurant manager

Modern professional occupations e.g. teacher, nurse, social worker, artist, musician, software designer

Routine manual and service occupations e.g. van driver, cleaner, porter, waiter/waitress, bar staff

Semi-routine manual/service occupation e.g. postal worker, security guard, machinist, receptionist, sales assistant

Senior manager/administrator e.g. finance manager, chief executive

Technical and craft occupation e.g. fitter, plumber, printer, electrician

Traditional professional occupation e.g. accountant, solicitor, scientist, medical practitioner

Long-term unemployed e.g. claimed Jobseeker's Allowance or earlier unemployment benefit for more than a year

Prefer not to say

Other (e.g. independent income) please specify

This question does not apply to me