THE JAMES TUDOR FOUNDATION

EQUAL OPPORTUNITIES MONITORING FORM

We are committed to equal opportunities in employment, and welcome applications from all sections of the community.

This information will be used solely for monitoring purposes, in order to see to what extent our advertisement and recruitment procedures are attracting a wide range of candidates across the spectrum of gender, race, disability, and age. It will be treated as confidential, and will not be used in the recruitment process.

Please tick as appropriate.

1. Are you: male_____ female_____

2. How would you describe your ethnic origin:

White:

British___ Irish___ Welsh___ Scottish___ English___

Other white background___

Mixed:

White and Black Caribbean___ White and Black African___

White and Asian___ Other mixed background___

Asian or Asian British:

Indian___ Pakistani___ Bangladeshi___

Any other Asian background___

Black or Black British:

Caribbean___ African___ Any other Black background___

Chinese or other ethnic group:

Chinese___ Any other ethnic group not outlined above___

Prefer not to say___

3. Do you consider yourself disabled?

Yes___ No___

4. How old are you?

Under 21____ 21 – 30____ 31 – 40____ 41 – 50____

51 – 65____ 66 – 75____ 75+____