Strictly Confidential
Equality Data Monitoring Form (Confidential Once Completed)
Why should you complete this form?
Equality data helps the University to ensure that we are being fair and that we successfully nurture talent within the University community. It also helps us to get the services and benefits that we provide right. Youdo not have to complete this form, or some of the questions, if you do not want to, and this will not affect how we treat you. We hope, however, that you will feel comfortable to do so. Your contribution will add to creating an inclusive working environment.
How will we use your data?
The fields below allow you to update the information that the University holds about your identity. Equality monitoring data is recorded centrally within HR, solely for anonymised monitoring and reporting purposes. It is sensible to feel cautious about disclosing any personal information, but please feel assured that we will always protect the information you share and that we will actively use it to improve University policy and practiceswithout compromising your anonymity at any time.
Equality Data Fields- Employee Number: …………………
- What is your legal sex?
What is your gender identity?
Female
Male
- What is your ethnic origin?
Asian or Asian British – Bangladeshi
Asian or Asian British – Indian
Asian or Asian British – Pakistani
Black or Black British – African
Black or Black British – Caribbean
Chinese
Gypsy or Traveller
Mixed White and Asian
Mixed White and Black African
Mixed White and Black Caribbean
Form continues overleaf . . .
Other Asian background
Other Black background
Other Chinese background
Other ethnic background
Other mixed background
Other White background
White British
White British Other
White Irish
White Scottish
White Welsh
Prefer not to say
- What is your religion?
Christian
Christian – Church of Ireland
Christian – Church of Scotland
Christian – Presbyterian Church in Ireland
Christian – Roman Catholic
Christian – other denomination
Hindu
Humanist
Jewish
Muslim
Pagan
Sikh
Spiritual
Any other religion or belief
No religion
Prefer not to say
- Which of the following options best describes your sexual orientation? Please note that the binary separation of gay man/gay woman is based on current HESA categories, which our statutory duty requires us to report on.
Gay man
Gay woman/lesbian
Heterosexual
Prefer not to say
Other
Form continues overleaf . . .
- Are you disabled?
Blind or serious visual impairment
Deaf or serious hearing impairment
General learning disability (such as Down’s syndrome)
A long-standing illness or health condition (such as cancer, diabetes,
chronic heart disease, epilepsy or HIV)
A mental health condition (such as depression, schizophrenia or
anxiety disorder)
No known disability
Other disability, impairment or medical condition
A physical impairment or mobility issues
Prefer not to say
A social/communication impairment (such as Asperger’s syndrome
or autistic spectrum disorder)
A specific learning difficulty (such as dyslexia, dyspraxia or ADHD)
Two or more impairments or disabling conditions
Thank you for completing this form and helping us to unlock people’s potential in ourworking environment.
Additional guidelines:
- Please note that Equality Data Monitoring Forms should be sent directly by employees to order to maintain confidentiality.
- A copy of the form may be stored confidentially as sensitive personal data.
- Because this form is stored confidentially, we will not be able to follow up with you on any particular circumstances that you disclose here. If completing this form has raised issues that you would like us to take forward, please contact HR via the email address above. You may also find the Equality & Diversity pages of the website helpful:
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