Print Name: Date: 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 under 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. Sexual orientation Please Ethnic group Workforce Please tick census tick code Bi-sexual Gay White WBRI British English Welsh Northern Irish Scottish WIRI Irish Lesbian OOTH Irish Traveller Heterosexual OOTH Gypsy Other WOTH Other White background Prefer not to say Mixed MWBC White and Black Caribbean MWBA White and Black African MWAS White and Asian Gender Please MOTH Other Mixed background tick Asian or AIND Indian Female Asian British Male APKN Pakistani Transgender ABAN Bangladeshi Prefer not to say CHNE Chinese AOTH Other Asian background Black or Black BCRB Caribbean Personal Please British relationship tick BAFR African Single BOTH Other Black background Living together Other ethnic OOTH Arab Married group Civil Partnership Write in: Prefer not to say Prefer not to REFU say Disability Please tick Do you consider that you have a disability? Yes - Please complete the grid below
Print Name: Date: 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 under 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 group Workforce census code Please tick White WBRI British English Welsh Northern Irish Scottish WIRI Irish OOTH Irish Traveller OOTH Gypsy 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 Black or Black British BCRB Caribbean BAFR African BOTH Other Black background Other ethnic group OOTH Arab Write in: Prefer not to say REFU Sexual orientation Please tick Bi-sexual Gay Lesbian Heterosexual Other Prefer not to say Gender Please tick Female Male Transgender Prefer not to say Personal relationship Please tick Single Living together Married Civil Partnership Prefer not to say Disability Do you consider that you have a disability? Please tick Yes - Please complete the grid below
EP-Support-Staff-Application-Form-January-2017.docx