Equal opportunities monitoring form –[Project coordinator and senior researcher – maternity cover]
The McPin Foundation is committed to equal opportunities, fairness of treatment, dignity, and the elimination of all forms of discrimination in the workplace for employees and job applicants. We strive for an environment in which all individuals are able to make best use of their skills, free from discrimination or harassment, and in which all decisions are based on merit.
The information in this form is being gathered to monitor the operation of the McPin Foundation’s Equal Opportunities policies and the effectiveness of advertising media used, and for no other reason. The data will be treated in confidence. It will not be taken into account in assessing information on your application form and is not seen by the short listing panel. Please tick one response per question below or if completing online highlight your answer using a cross (X) and bold your response. E.g. Age 30-44 X
GENDER
Female Male Non-binary/other (please specify) ______
Prefer not to say
Do you identify as transgender?
Yes No Questioning/unsure Prefer not to say
ETHNICITY Iwould describe my ethnicity as (please tick ONE box):
Asian, Asian British, Asian English, Black, Black British,Chinese, Chinese British,Chinese English,
Asian Scottish, or Asian Welsh Black English, BlackChineseScottish, Chinese Welsh
IndianScottish, or Black Welshor other ethnic group
Pakistani Caribbean
Bangladeshi African Chinese
Any other Asian background Any other Black background Any other background (please specify)______(please specify______(please specify) ______
MixedWhite
White & Black CaribbeanBritish: Irish
White & Black African English Any other White background
White & Asian Scottish(please specify)______
Any other Mixed background Welsh
(please specify)______ Other(please specify) ______ Prefer not to say
MARITAL STATUSI am: Civil partnership Divorced Married
Partnered Single Widowed Prefer not to say
SEXUAL ORIENTATIONI am: Bisexual Gay Heterosexual
Lesbian Questioning/unsure
Other (please specify) ______
Prefer not to say
DISABILITYDo you consider yourself to have a disability? Yes No
Definition of Disability: Section 1 of the Disability Discrimination Act defines a person as having a disability of he/she "has a physical or mental impairment which has a substantial and long-term adverse effect on their ability to carry out normal day to day activities".
Do you consider yourself to have a sensory disability?Yes / No
Do you consider yourself to have a learning disability? Yes / No
Do you consider yourself to have a physical disability?Yes / No
Do you consider yourself to have a disability related to you mental health?Yes/ No
CARING RESPONSIBILITIES
Do you look after someone from any of the following groups?
A childYes / No
An adultYes / No
Someone with a sensory, learning or physical disability
Someone with a disability related to his/her mental health
Other, please specify______
Prefer not to say
AGE Under 30 30 - 44 45 or over
RELIGION OR BELIEFI have: No religion or belief Buddhist Christian
Hindu Jewish Muslim Sikh
Other (please specify) ______
Prefer not to say
MEDIAHow did you hear about this vacancy?
Job Centre McPin website
Advert(please state e.g. other website) Other (please state e.g. word of mouth)
______
By completing this form I understand that I give my explicit consent under the Data Protection Act 1998 for the McPin Foundation to retain this information for up to one year after the end of the recruitment exercise.
In order to preserve your anonymity you can send this form by post to:McPin Foundation, 32-36 Loman Street, London, SE1 0EH.
Alternatively please email to where it will be stored separate from your application form and unattached to your email address.