DIVERSITY MONITORING FORM Public appointments are made on merit in accordance with the Cabinet Office Governance Code and the Public Appointments Order in Council. By completing the attached diversity monitoring form you will be helping us meet our public sector equality duty under section 149 of the Equality Act 2012 and section 75 of the Northern Ireland Act 1998. Your personal data will always be treated in confidence and when anonymised with data from other applicants will help compile the Annual Statistical Bulletin of the Commissioner for Public Appointments. Your responses to sections 1 9 will never be made available to the panel considering your application. – 1. Gender What is your gender? Female Male I prefer to describe myself as ___________________________________ I prefer not to say 2. Disability Do you consider yourself to be disabled? No Yes I prefer not to say 3. Ethnicity Please mark the box that most accurately describes your ethnicity: What is your ethnic group? Choose one option that most accurately describes your ethnic group or background White English / / Scottish / Northern Irish / British Gypsy or Irish Traveller Any other White background, please describe ______________________________________ Mixed / Multiple ethnic groups and Black Caribbean White and Black African White and Asian Any other Mixed / Multiple ethnic background, please describe _________________________ Asian / Asian British Indian Pakistani Bangladeshi Chinese Any other Asian background, please describe ______________________________________ Black African / Caribbean / Black British African
DIVERSITY MONITORING FORM Public appointments are made on merit in accordance with the Cabinet Office Governance Code and the Public Appointments Order in Council. By completing the attached diversity monitoring form you will be helping us meet our public sector equality duty under section 149 of the Equality Act 2012 and section 75 of the Northern Ireland Act 1998. Your personal data will always be treated in confidence and when anonymised with data from other applicants will help compile the Annual Statistical Bulletin of the Commissioner for Public Appointments. Your responses to sections 1 – 9 will never be made available to the panel considering your application. 1. Gender What is your gender? Female Male I prefer to describe myself as ___________________________________ I prefer not to say 2. Disability Do you consider yourself to be disabled? No Yes I prefer not to say 3. Ethnicity Please mark the box that most accurately describes your ethnicity: What is your ethnic group? Choose one option that most accurately describes your ethnic group or background White English / / Scottish / Northern Irish / British Gypsy or Irish Traveller Any other White background, please describe ______________________________________ Mixed / Multiple ethnic groups and Black Caribbean White and Black African White and Asian Any other Mixed / Multiple ethnic background, please describe _________________________ Asian / Asian British Indian Pakistani Bangladeshi Chinese Any other Asian background, please describe ______________________________________ Black African / Caribbean / Black British African
10088_VAPC_Diversity-form-O.docx