Aston-Mansfield

Recruitment Monitoring Form

Strictly Confidential

We are committed to equal opportunities in our recruitment procedures and wish to be able to monitor any occurrence of unfair discrimination. It will help us if you will complete the following questions. Please read the Equal Opportunities Statement attached.

Ethnic origin questions are not about nationality, place of birth or citizenship. They are about colour and broad ethnic group. UK citizens can belong to any of the groups indicated.

What is your ethnic group?
Choose ONE section from A to E, then tick the appropriate box to indicate your cultural background.
A / White
/ British
/ Irish
/ Any other White background, please write in

B / Mixed
/ White and Black Caribbean
/ White and Black African
/ White and Asian
/ Any other Mixed background, please write in

C / Asian or Asian British
/ Indian
/ Pakistani
/ Bangladeshi
/ Any other Asian background, please write in

D / Black or Black British
/ Caribbean
/ African
/ Any other Black background, please write in

E / Chinese or other ethnic group
/ Chinese
/ Any other, please write in

What is your age?

Under 25 26-45 46-55 over 56

What is your gender?

MaleFemale

How did you come to know about this vacancy?

Charity Jobs; CIU Mailout;

Other: (please specify):

Do you have any comments on this form which will help us improve our monitoring information?

Thank you for your help. Please return this form with your application. It will not be shown to anyone involved in the recruitment process

Equal Opportunities Statement

Aston-Mansfield is committed to ensuring equality of opportunity in its recruitment and employment practices.

No job or employee will be treated less favourably than others on the grounds of race, gender, nationality, marital status, employment status, class, disability, sexuality, age, religious belief, political persuasion, trade union activity or H.I.V status.

The organisation is also committed to ensuring that its staff reflects the communities we serve. In order to achieve these aims we have a policy of monitoring the composition of our staff.

As part of this monitoring process we ask for your co-operation in completing the questions in this section. We wish to give you the following assurances:

 The information provided will not form the basis of any part of the short-listing or selection

 The information from this form will be regarded as confidential and will only be used for statistics

 Should you choose not to complete this form it will not affect your application