BIRMINGHAM VOLUNTARY SERVICE COUNCIL APPLICATION FORM NO: (for office use only) …………… EQUAL OPPORTUNITIES MONITORING PART TWO The information provided in PART TWO will be kept separately from the application form, will only be used for statistical monitoring and will be kept in confidence. The form will not be shown to the selection panel and will be destroyed after six months if you are unsuccessful. Job Reference No. Team Challenge Officer 107 - (INVOLVE project) Where did you see it advertised Gender: Male Female Date of Birth: Ethnic Origin: Choose one section and tick the appropriate box to indicate the cultural background to which you consider you belong. categories are based on the 2001 Census. ASIAN OR ASIAN BRITISH BLACK OR BLACK BRITISH Indian Pakistani Bangladeshi Caribbean African Kashmiri Any other Black background (please state) Any other Asian background (please state) ________________________ ____________________________ CHINESE OR OTHER ETHNIC GROUP Chinese Vietnamese Any other (please state) ________________________ MIXED WHITE White and Black Caribbean British White and Black African Any other White background (please state) White and Asian ___________________________
BIRMINGHAM VOLUNTARY SERVICE COUNCIL APPLICATION FORM NO: …………… (for office use only) EQUAL OPPORTUNITIES MONITORING PART TWO The information provided in PART TWO will be kept separately from the application form, will only be used for statistical monitoring and will be kept in confidence. The form will not be shown to the selection panel and will be destroyed after six months if you are unsuccessful. Job Reference No. 107 - Team Challenge Officer (INVOLVE project) Where did you see it advertised Gender: Male Female Date of Birth: Ethnic Origin: Choose one section and tick the appropriate box to indicate the cultural background to which you consider you belong. categories are based on the 2001 Census. ASIAN OR ASIAN BRITISH Indian Pakistani Bangladeshi Kashmiri Any other Asian background (please state) ____________________________ BLACK OR BLACK BRITISH Caribbean African Any other Black background (please state) ________________________ CHINESE OR OTHER ETHNIC GROUP Chinese Vietnamese Any other (please state) ________________________ MIXED White and Black Caribbean White and Black African White and Asian WHITE British Any other White background (please state) ___________________________
107%20-%20Application%20Form.docx