Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong. White, any other white White, British White, Irish ☐ ☐ background ☐ Asian or Asian British, Asian or Asian British, Asian or Asian British, Bangladeshi Indian Pakistani ☐ ☐ ☐ Asian or Asian British, Black or Black British, Black or Black British, Any other Asian African Caribbean ☐ ☐ background ☐ Black or Black British, Mixed or any other Chinese ☐ Any other Black mixed background ☐ background ☐ Mixed White & Black Mixed White & Asian Mixed White & Black African☐ ☐ Caribbean ☐ Traveller of Irish Any other ethnic Gypsy/Roma ☐ background please Heritage ☐ specify: Prefer not to say ☐ Do you consider yourself to have a disability? Yes No Prefer not to say ☐ ☐ ☐ The information in this form is for monitoring purposes only. If you believe that you need a please discuss this with your manager. ‘reasonable adjustment’ then What is your sexual orientation? Heterosexual Gay woman / lesbian Gay man Bisexual ☐ ☐ ☐ ☐ If you prefer to use your own term, please specify here: Prefer not to say ☐ What is your religion or belief? No religion or belief Buddhist Christian Hindu Jewish ☐ ☐ ☐ ☐ ☐ Muslim Sikh Prefer not to say ☐ ☐ ☐ If other religion or belief please state: I consent to this information being used by the school and Creative Education Trust ☐ for equality monitoring and statutory purposes (for example the school workforce census). Signed: Date:
Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong. White, British ☐ White, Irish ☐ White, any other white background ☐ Asian or Asian British, Bangladeshi ☐ Asian or Asian British, Indian ☐ Asian or Asian British, Pakistani ☐ Asian or Asian British, Any other Asian background ☐ Black or Black British, African ☐ Black or Black British, Caribbean ☐ Black or Black British, Any other Black background ☐ Chinese ☐ Mixed or any other mixed background ☐ Mixed White & Asian ☐ Mixed White & Black African☐ Mixed White & Black Caribbean ☐ Traveller of Irish Heritage ☐ Gypsy/Roma ☐ Any other ethnic background please specify: Prefer not to say ☐ Do you consider yourself to have a disability? Yes ☐ No ☐ Prefer not to say ☐ The information in this form is for monitoring purposes only. If you believe that you need a ‘reasonable adjustment’ then please discuss this with your manager. What is your sexual orientation? Heterosexual ☐ Gay woman / lesbian ☐ Gay man ☐ Bisexual ☐ Prefer not to say ☐ If you prefer to use your own term, please specify here: What is your religion or belief? No religion or belief ☐ Buddhist ☐ Christian ☐ Hindu ☐ Jewish ☐ Muslim ☐ Sikh ☐ Prefer not to say ☐ If other religion or belief please state: ☐ I consent to this information being used by the school and Creative Education Trust for equality monitoring and statutory purposes (for example the school workforce census). Signed: Date:
Equality_and_diversity_monitoring_form_staff_print_version-1.docx