MONITORING FORM
The Arts Marketing Association is committed to making sure its Equal Opportunities and Diversity policy is effective.
In particular, the AMA aims to ensure that no-one receives less favourable treatment on the grounds of race, colour, nationality, ethnic or national origin, sex, culture, disability, marital status, sexuality, age or religion.
Monitoring is part of this process and will help us to identify areas of under-representation among applications for AMA vacancies and to assess those areas where positive action may be needed in future.
All information the AMA collects around equality and diversity will be treated confidentially in accordance with the Data Protection Act. Access to this information will be restricted to staff involved in the processing and monitoring of this data. It will be used to provide statistical information only.
Your co-operation in completing the attached form is greatly appreciated. We stress that any information you give will be treated as strictly confidential. You are not obliged to answer any of the following questions, although your participation will help us greatly in reaching a more diverse pool of applicants in the future.
1.Position applying for:
- Page 1 of 4 -
Administration and Finance Coordinator
- Page 1 of 4 -
2.Please indicate your age.
- Page 1 of 4 -
years months
- Page 1 of 4 -
3.Do you consider yourself to have a disability according to the terms given in the Equality Act 2010?
You are disabled under the Equality Act 2010 if you have a physical or mental impairment that has a ‘substantial’ and ‘long term’ (i.e. 12 months or more) negative effect on your ability to do normal daily activities.
☐ Yes
☐ No
☐ Unsure
☐ Prefer not to say
4.If you have answered yes, please indicate the type of impairment which applies to you.
If you experience more than one type of impairment, please tick all the types that apply. If your disability does not fit any of these types, please mark 'Other' and specify.
☐ Physical/mobility impairment, such as a difficulty using your arms or mobility issues which require you to use a wheelchair or crutches
☐ Visual impairment, such as being blind or having a serious visual impairment
☐ Hearing impairment, such as being deaf or having a serious hearing impairment
☐ Mental health condition, such as depression or schizophrenia
☐ Learning disability/difficulty, such as Down’s syndrome or dyslexia or a cognitive impairment such as autistic spectrum disorder
☐ Long-standing illness or health condition, such as cancer, HIV, diabetes, chronic heart disease or epilepsy
- Page 1 of 4 -
☐ Any other (please specify):
- Page 1 of 4 -
5.Please tick the ethnic category that best represents you.
As you make your decision, please think about what ethnic group means to you, that is, how you see yourself. Your ethnicity is a mixture of culture, religion, skin colour, language and the origins of yourself and your family. It is not the same as nationality.
☐Arab
☐Asian or Asian British – Bangladeshi
☐ Asian or Asian British – Chinese
☐ Asian or Asian British – Indian
☐ Asian or AsianBritish – Pakistani
- Page 1 of 3 -
☐Any other Asian background:
- Page 1 of 3 -
☐Black or Black British – African
☐ Black or Black British – Caribbean
- Page 1 of 3 -
☐Any other Black background:
- Page 1 of 3 -
☐Dual heritage - Asian and White
☐ Dual heritage - Black African and White
☐ Dual heritage - Black Caribbean and White
- Page 1 of 3 -
☐Any other dual heritage background:
- Page 1 of 3 -
☐White - British
☐ White – English
☐ White – Gipsy or traveller
☐ White – Irish
☐ White - Scottish
☐ White – Welsh
- Page 1 of 3 -
☐Any other White background:
☐Any other:
- Page 1 of 3 -
☐Prefer not to say
6.Please tick yourreligion or belief
☐Bahai
☐Buddhist
☐ Christian
☐ Hindu
☐Jain
☐Jewish
☐Muslim
☐ No religion
☐ Sikh
☐Spiritual
- Page 1 of 3 -
☐ Any other (please specify):
- Page 1 of 3 -
☐ Prefer not to say
7.Please tick the gender that best represents you
☐ Female
☐ Male
- Page 1 of 3 -
☐ (fill in the blank)
- Page 1 of 3 -
☐ Prefer not to say
8.Do you identify as transgender?
For the purpose of this question ‘transgender’ is defined as an individual who lives, or wants to live, in the gender opposite to that they were assigned at birth.
☐ Yes
☐ No
☐ Prefer not to say
9.Please tick the sexual orientation category that best represents you.
☐ Bisexual
☐ Gay man
☐Gay woman/lesbian
☐ Heterosexual
☐Other
☐Unsure
☐ Prefer not to say
10.Please tick the marital status category that best represents you.
☐ Co-habiting
☐ Divorced
☐ Married / Civil Partnership
☐ Separated
☐ Single
☐ Widowed
☐ Prefer not to say
11.Pregnancy and maternity – are you pregnant, on maternity leave or returning from maternity leave?
☐ Yes
☐ No
☐ Prefer not to say
12.Do you have dependants? Dependants might include children, the elderly,or other people who rely on you for care.
☐ Yes
☐ No
☐ Prefer not to say
MEDIA PROFILE
Where did you see this post advertised?
- Page 1 of 3 -
- Page 1 of 3 -