EQUAL OPPORTUNITIES RECRUITMENT MONITORING FORM Please complete this monitoring form and return with your application form. Diversity and equality are at the heart of every activity in E-ACT. E-ACT is committed to equal opportunities in employment, with the aim of ensuring that everyone who applies to work for us receives fair treatment. To help us achieve this aim we ask you to complete this monitoring form. This information will be used to monitor the effectiveness of our Diversity and Equality Policy and for no other reason. The request for this information and how it is used is within the scope of the Data Protection Act 1998 which allows for the collation and reporting of sensitive data for monitoring purposes. This information will be kept separate from your application form to ensure that none of the information you have provided is used in the selection decision. POST APPLIED FOR HOW TO COMPLETE THIS FORM:- Please mark your response by putting an in the box. ‘X’ Ethnic Origin: I would describe my racial or cultural origin as: White: British Irish Other Please specify or Black African Caribbean Other Please specify British: Asian or Asian Indian Pakistani Bangladeshi Other British: Please specify Dual or Multiple White and Asian White and Black White and Any other dual Heritage: African Black or mulitple Caribbean heritage Please specify Chinese or Other Chinese Any other Ethic Irish/Gypsy Roma Ethnic Group: Background Traveller Please specify Prefer not to say Monitoring Disability: Do you consider yourself to have a disability as defined in the Equalities Act 2010? The Act defines disability as: physical or mental impairment which has a substantial and long-term effect on a “a person’s ability to carry out normal day to day activities”. Please mark with an “x” Yes No Prefer not to say If yes please give a brief description of your disability below : Monitoring Gender: What you describe yourself as: Male Female Prefer not to say Monitoring Gender: Is your present gender the same as the one assigned to you at birth?
EQUAL OPPORTUNITIES RECRUITMENT MONITORING FORM Please complete this monitoring form and return with your application form. Diversity and equality are at the heart of every activity in E-ACT. E-ACT is committed to equal opportunities in employment, with the aim of ensuring that everyone who applies to work for us receives fair treatment. To help us achieve this aim we ask you to complete this monitoring form. This information will be used to monitor the effectiveness of our Diversity and Equality Policy and for no other reason. The request for this information and how it is used is within the scope of the Data Protection Act 1998 which allows for the collation and reporting of sensitive data for monitoring purposes. This information will be kept separate from your application form to ensure that none of the information you have provided is used in the selection decision. POST APPLIED FOR HOW TO COMPLETE THIS FORM:- Please mark your response by putting an ‘X’ in the box. Ethnic Origin: I would describe my racial or cultural origin as: White: British Irish Other Please specify or Black British: African Caribbean Other Please specify Asian or Asian British: Indian Pakistani Bangladeshi Other Please specify Dual or Multiple Heritage: White and Asian White and Black African White and Black Caribbean Any other dual or mulitple heritage Please specify Chinese or Other Ethnic Group: Chinese Any other Ethic Background Please specify Irish/Gypsy Traveller Roma Prefer not to say Monitoring Disability: Do you consider yourself to have a disability as defined in the Equalities Act 2010? The Act defines disability as: “a physical or mental impairment which has a substantial and long-term effect on a person’s ability to carry out normal day to day activities”. Please mark with an “x” Yes No Prefer not to say If yes please give a brief description of your disability below : Monitoring Gender: What you describe yourself as: Male Female Prefer not to say Monitoring Gender: Is your present gender the same as the one assigned to you at birth?
Updated-Oct-2017-E-ACT-Equal-Opportunities-Monitoring-Form1.docx