Official use only Application no: Monitoring information This section of the application form will be detached from your application form and will be used for monitoring purposes only. NHS Organisations recognise and actively promote the benefits of a diverse workforce and are committed to treating all employees with dignity and respect regardless of race, gender, disability, age, sexual orientation, religion or belief. We therefore welcome applications from all sections of the community. *Date of Birth Male Female *Gender I do not wish to disclose this information *I would describe my ethnic origin as follows: Asian or Asian British Mixed Other Ethnic Group Bangladeshi White & Asian Chinese Indian White & Black African Any other ethnic group Pakistani White & Black Caribbean Any other Asian background Any other mixed I do not wish to background disclose this Black or Black British White African British Caribbean Cornish Any other Black background Irish Any other White background * Please select the option which best describes your sexual orientation
Official use only Application no: Monitoring information This section of the application form will be detached from your application form and will be used for monitoring purposes only. NHS Organisations recognise and actively promote the benefits of a diverse workforce and are committed to treating all employees with dignity and respect regardless of race, gender, disability, age, sexual orientation, religion or belief. We therefore welcome applications from all sections of the community. *Date of Birth *Gender Male Female I do not wish to disclose this information *I would describe my ethnic origin as follows: Asian or Asian British Bangladeshi Indian Pakistani Any other Asian background Black or Black British African Caribbean Any other Black background Mixed White & Asian White & Black African White & Black Caribbean Any other mixed background White British Cornish Irish Any other White background Other Ethnic Group Chinese Any other ethnic group I do not wish to disclose this * Please select the option which best describes your sexual orientation
GoverningBodyLayMemberApplicationForm.docx