Age 16-18 yrs 19-21 yrs 22-35 yrs 36-45 yrs 46-64 yrs 65 yrs + Prefer not to say Disability Do you consider that you have a disability? Yes No Prefer not to say If Yes, please give brief details of the disability and any adjustments that would need to be made to enable you to carry out the duties listed for this post (continue on a separate sheet if necessary). Race Please read all the categories and then tick the box that applies to you White British Irish Any other white background (please state) Mixed race White and White and White and Any other mixed background black black Asian (please state) Caribbean African Asian or Asian British Indian Pakistani Bangladeshi Any other Asian background (please state) Black or Black British Caribbean African Any other black background (please state)
Age 16-18 yrs 19-21 yrs 22-35 yrs 36-45 yrs 46-64 yrs 65 yrs + Prefer not to say Disability Do you consider that you have a disability? Yes No Prefer not to say If Yes, please give brief details of the disability and any adjustments that would need to be made to enable you to carry out the duties listed for this post (continue on a separate sheet if necessary). Race Please read all the categories and then tick the box that applies to you White British Irish Any other white background (please state) Mixed race White and black Caribbean White and black African White and Asian Any other mixed background (please state) Asian or Asian British Indian Pakistani Bangladeshi Any other Asian background (please state) Black or Black British Caribbean African Any other black background (please state)