Marital Status (please tick appropriate) Married Divorced Separated Single Partnered Race, Nationality, Ethnic Origin (Please Tick as appropriate) White Mixed Welsh English White and Black Caribbean White and Asian Irish Scottish White and Black British White and Black African Other white background (please specify) Other mixed background (please specify) _______________________________ _________________________________________ Asian Indian Pakistani Caribbean African Bangladeshi British British Other Asian background (please specify) Other black background (please specify) _____________________________ __________________________________________ Sexual Orientation (Please tick as appropriate) Heterosexual Homosexual Bisexual Transsexual Prefer not to say Religion Please state preferred religion or belief Disability None Physical Disability Mental Disability Prefer not to say If you are disabled please give brief details of the effects of your disability on your day-to-day activities, and any other information that you feel would help us accommodate your needs during your interview/assessment and thus meet our obligations under the Equality Act 2010: Welsh Language Are you a Welsh speaker Yes No Where did you see the advertisement for this post? At a Facility Local Press Internet Job Centre Professional Publication Word of Mouth JOB APPLICATION FORM
Marital Status (please tick appropriate) Married Divorced Separated Single Partnered Race, Nationality, Ethnic Origin (Please Tick as appropriate) White Welsh English Irish Scottish Other white background (please specify) _______________________________ Mixed White and Black Caribbean White and Asian White and Black British White and Black African Other mixed background (please specify) _________________________________________ Asian Indian Pakistani Bangladeshi British Other Asian background (please specify) _____________________________ Caribbean African British Other black background (please specify) __________________________________________ Sexual Orientation (Please tick as appropriate) Heterosexual Homosexual Bisexual Transsexual Prefer not to say Religion Please state preferred religion or belief Disability None Physical Disability Mental Disability Prefer not to say If you are disabled please give brief details of the effects of your disability on your day-to-day activities, and any other information that you feel would help us accommodate your needs during your interview/assessment and thus meet our obligations under the Equality Act 2010: Welsh Language Are you a Welsh speaker Yes No Where did you see the advertisement for this post? At a Facility Local Press Internet Job Centre Professional Publication Word of Mouth JOB APPLICATION FORM