Recruitment Monitoring

––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––RECRUITMENT MONITORING

Iam:Female☐Male ☐

Dateof Birth:

TohelpusmonitorourEqualOpportunitiesinEmploymentPolicypleasetickorcompletethefollowingboxesas appropriate:

ETHNICORIGIN

Chooseonesectionfrom (A)to(E) thentick theappropriateboxtoindicateyourculturalbackground.Thesearebased onthe2011Censuswithadditionalcategoriesincluded.

AWhite

British☐Irish☐GypsyorIrishTraveller☐Albanian ☐

AnyotherWhitebackground,pleaseindicate:

BMixed

White/Black–Caribbean☐White/Asian☐White/Black–Africa☐Black/Asian ☐

Anyothermixedbackgroundpleaseindicate:

CAsianorAsianBritish

Indian☐Kashmiri☐Pakistani☐Bangladeshi☐Chinese ☐

AnyotherAsianbackground,pleaseindicate:

DBlackorBlackBritish

Caribbean☐African ☐

AnyotherBlackbackground,pleaseindicate:

EOtherethnicgroup

Arab☐Kurdish☐Vietnamese ☐

Anyotherpleaseindicate:

Notdisclosed☐

DISABILITY

TheEqualityAct2010definesapersonashavingadisabilityifhe/shehasaphysicalormentalimpairmentwhichhasa substantialandlongtermadverseeffectonhis/herabilitytocarryoutnormaldaytodayactivities.

Doyouhaveadisabilityasdefinedabove?Yes:☐ No:☐

Ifallof theabovedoesnotapplytoyou,however,you consideryourselftohaveadisability,pleasetick here ☐

EMPLOYMENT STATUS

Are you currently employed by Birmingham City Council? Yes:☐ No:☐

Ifyes pleasestateifyouareemployedonatemporary,casualorpermanentbasis:Yes:☐ No:☐

Are you currently employed by a school in Birmingham?Yes:☐ No:☐

If yes please state if you are employed on a temporary, casual or permanent basis:

Areyoucurrentlyunemployed?Yes:☐ No:☐

WHATISYOURSEXUALORIENTATION?

Bisexual☐LesbianorGay☐Heterosexual☐NotDisclosed ☐

RELIGION

Christian– (includingCatholic,Cof E, ProtestantandallotherChristiandenominations) ☐Buddhist☐ Hindu☐ Jewish☐ Muslim☐ Sikh ☐

Noreligion☐Notdisclosed☐Other-pleasespecify: ☐

JOBADVERTISEMENT

Howdidyoufirstfindoutaboutthisjob? Pleasespecifythesourceorpublication.

TeachingVacancyBulletin☐BirminghamCityCouncilWebsite☐WMJobs.co.uk ☐

Twitter☐TESon-line☐Guardianon-line☐

Facebook☐Indeed☐Birmingham Mail ☐

Other(pleasespecify): Printed publication (please specify)