Gender Male Female Disability Yes No If Yes, Please state nature of disability The Disability Discrimination Act defines disability as: physical or mental impairment which has a substantial and long-term effect on the person's ability to carry out “A normal day-to-day activities” Ethnicity Please tick one option only White Mixed White British White and Asian White Irish White and Black African White European White and Black Caribbean Mixed Other Asian Asian British Black Indian Black British Pakistani Black African Bangladeshi Black Caribbean Chinese Other Black background Asian Background Any other ethnic group Other Chinese/ Vietnamese Arab Cypriot Greek Other ethnic background Cypriot Turkish Cypriot Other Prefer not to say Any other ethnic group
Gender Male Female Disability Yes No If Yes, Please state nature of disability The Disability Discrimination Act defines disability as: “A physical or mental impairment which has a substantial and long-term effect on the person's ability to carry out normal day-to-day activities” Ethnicity Please tick one option only White White British White Irish White European Asian Asian British Indian Pakistani Bangladeshi Chinese Asian Background Other Arab Other ethnic background Prefer not to say Mixed White and Asian White and Black African White and Black Caribbean Mixed Other Black Black British Black African Black Caribbean Other Black background Any other ethnic group Chinese/ Vietnamese Cypriot Greek Cypriot Turkish Cypriot Other Any other ethnic group
city-gateway-application-form-73086.docx