Personnel monitoring information Lewisham Council has an equal opportunities policy and is keen to ensure that it is working efficiently. The information you provide in this section will be used for statistical monitoring only and is not part of the interview selection process. (Please tick the appropriate box) Gender, Age and Date of Birth: Female Age: Date of birth: Male Ethnic Origin: How would you define your ethnic origin. (2001 Census categories) White Mixed Asian or Asian British British White and Black Caribbean Indian Irish White and Black African Pakistani Turkish/Turkish Cypriot White and Asian Bangladeshi Any other white background Any other mixed background Tamil Any other Asian background Black or Black British Chinese or other ethnic group Decline to state Chinese African Vietnamese Any other black background Any other ethnic group Sexual Orientation: How would you define your sexual orientation. Religion/Belief: What is your religious belief. Bisexual Buddhist Jewish Gay Christian Muslim Heterosexual Hindu Sikh Lesbian Other Decline to state Decline to state Do you consider yourself disabled? Yes No Decline to state (Note: the Disability Discrimination Act says that this would be or long term physical or mental “a substantial impairment or health issue which could adversely affect your ability to carry on normal day to day activities”) Examples of Disabilities the following list of conditions or impairments is given as a guide only and is not meant to – be exclusive. We have provided this list as it may help you to answer the question Hearing, speech or visual impairments (if you wear glasses or contact lenses this is not normally considered a disability) Co-ordination, dexterity or mobility (eg polio, spinal cord injury, back problems, repetitive strain injury) Mental health (eg schizophrenia, depression, severe phobias) Speech Impairment (eg stammering) Learning Disabilities (eg Down’s Syndrome) Other physical or medical conditions (eg diabetes, epilepsy, arthritis, cardiovascular conditions, haemophilia, asthma, cancer, facial disfigurement, sickle cell, dyslexia, etc)
Personnel monitoring information Lewisham Council has an equal opportunities policy and is keen to ensure that it is working efficiently. The information you provide in this section will be used for statistical monitoring only and is not part of the interview selection process. (Please tick the appropriate box) Gender, Age and Date of Birth: Female Age: Date of birth: Male Ethnic Origin: How would you define your ethnic origin. (2001 Census categories) White Mixed Asian or Asian British British White and Black Caribbean Indian Irish White and Black African Pakistani Turkish/Turkish Cypriot White and Asian Bangladeshi Any other white background Any other mixed background Tamil Any other Asian background Black or Black British Chinese or other ethnic group Decline to state Chinese African Vietnamese Any other black background Any other ethnic group Sexual Orientation: How would you define your sexual orientation. Religion/Belief: What is your religious belief. Bisexual Buddhist Jewish Gay Christian Muslim Heterosexual Hindu Sikh Lesbian Other Decline to state Decline to state Do you consider yourself disabled? Yes No Decline to state (Note: the Disability Discrimination Act says that this would be “a substantial or long term physical or mental impairment or health issue which could adversely affect your ability to carry on normal day to day activities”) Examples of Disabilities – the following list of conditions or impairments is given as a guide only and is not meant to be exclusive. We have provided this list as it may help you to answer the question Hearing, speech or visual impairments (if you wear glasses or contact lenses this is not normally considered a disability) Co-ordination, dexterity or mobility (eg polio, spinal cord injury, back problems, repetitive strain injury) Mental health (eg schizophrenia, depression, severe phobias) Speech Impairment (eg stammering) Learning Disabilities (eg Down’s Syndrome) Other physical or medical conditions (eg diabetes, epilepsy, arthritis, cardiovascular conditions, haemophilia, asthma, cancer, facial disfigurement, sickle cell, dyslexia, etc)
Support-Staff-AppForm-KG116.docx