What is your Ethnic Origin? White and Black African Asian or Asian British White and Asian Indian Any other Mixed/Multiple Ethnic background Pakistani White Bangladeshi English/Welsh/Scottish/Northern Irish/British Chinese Irish Any other Asian background Gypsy or Irish Traveller Black or Black British Any other White background African Other Ethnic Group Caribbean Arab Any other Black background Any other background Mixed Prefer not to disclose White and Black Caribbean Do you consider yourself to have a disability, long-standing physical or mental health condition, illness or impairment? Yes No Prefer not to disclose If Yes To help your employer ensure appropriate support and/or adjustments are in place, – please explain in the box provided below if you will need any facilities or support relating to your disability, long-standing physical or mental health condition, illness or impairment?
What is your Ethnic Origin? Asian or Asian British Indian Pakistani Bangladeshi Chinese Any other Asian background Black or Black British African Caribbean Any other Black background Mixed White and Black Caribbean White and Black African White and Asian Any other Mixed/Multiple Ethnic background White English/Welsh/Scottish/Northern Irish/British Irish Gypsy or Irish Traveller Any other White background Other Ethnic Group Arab Any other background Prefer not to disclose Do you consider yourself to have a disability, long-standing physical or mental health condition, illness or impairment? Yes No Prefer not to disclose If Yes – To help your employer ensure appropriate support and/or adjustments are in place, please explain in the box provided below if you will need any facilities or support relating to your disability, long-standing physical or mental health condition, illness or impairment?
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