Name: Please mark the box with indicating the role you are applying for: ‘X’ NED 1: NED 2: NED 3: Ofcom is committed to equality of opportunity regardless of ethnicity, gender, sexual orientation, disability, age, religion and belief. Our vision is to build a corporate culture where equality and diversity is integral to our business policies and practices. By completing this monitoring form you will be helping Ofcom to ensure the realisation of our equality and diversity objectives. Please note that the form will be treated confidentially and used for monitoring purposes only. Data will only be used anonymously in aggregate form. Please mark the appropriate box with ‘X’ 1. Age Date of birth 2. Disability Do you consider yourself to have a disability? Yes No Do you meet the Disability Discrimination Act definition of disability? Yes No If you wish, you may indicate the nature of your disability: 3. Ethnic Origin Asian or Asian British Bangladeshi Indian Pakistani Any other Asian background Black or Black British African Caribbean Any other black background
Name: Please mark the box with ‘X’ indicating the role you are applying for: NED 1: NED 2: NED 3: Ofcom is committed to equality of opportunity regardless of ethnicity, gender, sexual orientation, disability, age, religion and belief. Our vision is to build a corporate culture where equality and diversity is integral to our business policies and practices. By completing this monitoring form you will be helping Ofcom to ensure the realisation of our equality and diversity objectives. Please note that the form will be treated confidentially and used for monitoring purposes only. Data will only be used anonymously in aggregate form. Please mark the appropriate box with ‘X’ 1. Age Date of birth 2. Disability Do you consider yourself to have a disability? Yes No Do you meet the Disability Discrimination Act definition of disability? Yes No If you wish, you may indicate the nature of your disability: 3. Ethnic Origin Asian or Asian British Bangladeshi Indian Pakistani Any other Asian background Black or Black British African Caribbean Any other black background
C4-Diversity-and-inclusion-form.docx