Print Name THIS PAGE IS INTENTIONALLY BLANK PART 3 EQUALITY AND DIVERSITY MONITORING This section will be separated from part 1 and part 2. Collection of equality information is solely for monitoring purposes to ensure that our policies and procedures are effective. We also collect this data in accordance with the general and specific public sector equality duties the Equality Act 2010. Any data you enter onto this monitoring form will only be used for monitoring purposes and will not be used in assessing and or scoring your application or during the interview process. This information is kept fully confidential and access is strictly limited in accordance with the Data Protection Act. Ethnic Workforce Census Code Please tick WBRI British English Welsh Northern Irish Scottish WIRI White OOTH Traveller OOTH WOTH Other White background MWBC White and Black Caribbean MWBA White and Black African Mixed MWAS White and Asian MOTH Other Mixed background AIND Indian APKN Pakistani Asian ABAN Bangladeshi or Asian British CHNE Chinese AOTH Other Asian background BCRB Caribbean BAFR African or British BOTH Other Black background Other ethnic group OOTH Arab in: Prefer not to say REFU Religion Disability Please tick Do you consider that you have a disability? Please tick No religion Yes Please complete the grid below Christian (including Church of England, No Catholic, Protestant and all other Christian Prefer not to say denominations) Buddhist My disability is: Please tick Hindu Physical Impairment Jewish Sensory Impairment Muslim Sikh Mental Health Condition Any other religion write in Learning Disability/ Difficulty Long standing illness Prefer not to say Other Prefer not to say Sexual Orientation Please tick Bi-sexual Gay Lesbian Heterosexual Other Prefer not to say Gender Please tick Female Male Transgender Prefer not to say Single Living together Married Civil Partnership
Print Name THIS PAGE IS INTENTIONALLY BLANK PART 3 EQUALITY AND DIVERSITY MONITORING This section will be separated from part 1 and part 2. Collection of equality information is solely for monitoring purposes to ensure that our policies and procedures are effective. We also collect this data in accordance with the general and specific public sector equality duties the Equality Act 2010. Any data you enter onto this monitoring form will only be used for monitoring purposes and will not be used in assessing and or scoring your application or during the interview process. This information is kept fully confidential and access is strictly limited in accordance with the Data Protection Act. Ethnic Workforce Census Code Please tick White WBRI British English Welsh Northern Irish Scottish WIRI OOTH Traveller OOTH WOTH Other White background Mixed MWBC White and Black Caribbean MWBA White and Black African MWAS White and Asian MOTH Other Mixed background Asian or Asian British AIND Indian APKN Pakistani ABAN Bangladeshi CHNE Chinese AOTH Other Asian background or British BCRB Caribbean BAFR African BOTH Other Black background Other ethnic group OOTH Arab in: Prefer not to say REFU Religion Disability Please tick Do you consider that you have a disability? Please tick No religion Christian (including Church of England, Catholic, Protestant and all other Christian denominations) Buddhist Hindu Jewish Muslim Sikh Any other religion write in Prefer not to say Yes Please complete the grid below No Prefer not to say My disability is: Please tick Physical Impairment Sensory Impairment Mental Health Condition Learning Disability/ Difficulty Long standing illness Other Prefer not to say Sexual Orientation Please tick Bi-sexual Gay Lesbian Heterosexual Other Prefer not to say Gender Please tick Female Male Transgender Prefer not to say Single Living together Married Civil Partnership
Middle-Leader-Application-Form.docx