St Hospice recognises the benefits of having a diverse workforce and welcomes applications from all sections of the community. In order to monitor the extent to which our workforce reflects Bristol’s diverse population, we request all applicants to provide us with the following information. . The information will be kept confidential and used for monitoring purposes. NAME: …………………………………… POST APPLIED FOR: ………………………………………… DATE OF BIRTH GENDER Male Please enter Female I do not wish to disclose MARITAL Married SEXUAL Lesbian STATUS Single ORIENTATION Gay Civil Partnership Bisexual Legally separated Heterosexual Divorced I do not wish to disclose Widowed I do not wish to disclose RELIGION OR Atheism Buddism Christianity BELIEF Hinduism Jainism Judaism Sikhism Other I do not wish to disclose Do you consider yourself to have a disability? Disability The Equality Act 2010 protects disabled people - Yes including those with long term health conditions, No learning disabilities and so called "hidden" disabilities I do not wish to disclose such as dyslexia. If you tell us that you have a disability we can make reasonable adjustments to ensure that If “yes” are you registered disabled? any selection processes - including the interview - are Yes fair and equitable No I do not wish to disclose Ethnic Origin How would you describe your ethnic origin? Please tick one box. Asian or Asian British: Black or Black British: Chinese: Indian Caribbean Chinese Bangladeshi African Pakistani Any other Black background Asian background Mixed Group: White: Other Ethnic Group: White and Black Caribbean British Other White and Black African Irish White and Asian Other White background mixed background
St Hospice recognises the benefits of having a diverse workforce and welcomes applications from all sections of the community. In order to monitor the extent to which our workforce reflects Bristol’s diverse population, we request all applicants to provide us with the following information. . The information will be kept confidential and used for monitoring purposes. NAME: …………………………………… POST APPLIED FOR: ………………………………………… DATE OF BIRTH Please enter GENDER Male Female I do not wish to disclose MARITAL STATUS Married Single Civil Partnership Legally separated Divorced Widowed I do not wish to disclose SEXUAL ORIENTATION Lesbian Gay Bisexual Heterosexual I do not wish to disclose RELIGION OR BELIEF Atheism Buddism Christianity Hinduism Jainism Judaism Sikhism Other I do not wish to disclose Disability The Equality Act 2010 protects disabled people - including those with long term health conditions, learning disabilities and so called "hidden" disabilities such as dyslexia. If you tell us that you have a disability we can make reasonable adjustments to ensure that any selection processes - including the interview - are fair and equitable Do you consider yourself to have a disability? Yes No I do not wish to disclose If “yes” are you registered disabled? Yes No I do not wish to disclose Ethnic Origin How would you describe your ethnic origin? Please tick one box. Asian or Asian British: Indian Bangladeshi Pakistani Asian background Black or Black British: Caribbean African Any other Black background Chinese: Chinese Mixed Group: White and Black Caribbean White and Black African White and Asian mixed background White: British Irish Other White background Other Ethnic Group: Other
1497005236_StandardApplicationFormJune2016.docx