Mencap diversity monitoring form

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Mencap is committed to fair employment practices and to employing a diverse workforce. You can refer to Mencap’s accessible diversity policy on the reverse of this form for more information.

To help us ensure our policy is being carried out, we need you to complete this form. We will keep it confidential. Your information will only be used for monitoring. If you are completing this alongside your application, please be assured that it will be separated from your application form. We do not use it at all for making decisions on who to appoint to a job.

Name (in CAPITALS):

I would describe my ethnic origin as:
White
English/Welsh/Scottish/Northern Irish
British
Irish
Gypsy or Irish Traveller
Any other White (please give details):
______
Mixed/multiple ethnic groups
White and Black Caribbean
White and Black African
White and Asian
Other mixed background
(please give details):
______
Asian or Asian British
Indian
Pakistani
Bangladeshi
Chinese
Other Asian background
(please give details):
______
Black /African/Caribbean/Black British
African
Caribbean
Other black/African/Caribbean background
(please give details):
______ / Other ethnic group
Arab
Any other (please give details):
______
Religion
No Religion
Christian (including Church of England, Catholic, Protestant and all other Christian denominations)
Buddhist
Hindu
Jewish
Muslim
Sikh
Any other religion(please give details):
______
For posts in Northern Ireland
I would describe my community background as
Protestant
Roman Catholic
Neither community
(please give details):
______
For posts in Mencap Cymru
In order to help us to monitor the number of Welsh speaking staff please state whether you are able to converse in Welsh
Yes – fluent
Yes – basic
No

Date of birth: Sex: Male Female

Do you consider yourself to have a disability? Yes No

Do you consider yourself to have a learning disability*? Yes No

Where did you see this job advertised?

For monitoring use only

Application reference number: Closing date:

*This means you find it harder to learn and understand things than most people. You may need support to do some things like cooking or getting dressed. You may need help with understanding numbers or talking to other people. Mencap does not include difficulties like dyslexia or dyspraxia within its definition of learning disability.

Diversity and equal opportunities at Mencap

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AtMencap we believe that everyone should have equal chances in life, no matter what their ability, ethnicity, gender, beliefs or life experience may be. We want to make sure that our services and support are available to everyone, and that they are used by people from different communities. We value difference and want to recruit and retain a diverse workforce, to increase the range of skills and talents within Mencap. This makes us stronger as an organisation.

Mencap wants to support and work with people with a learning disability, their families and carers from different backgrounds.

These include:

  • disabled people and non-disabled people
  • people from black and Asian communities and white people
  • men and women
  • older people and younger people
  • people of different religions or beliefs
  • people of different sexual orientations.

We really want people with a learning disability to be involved in running Mencap.

Mencap is here to make life better for people with a learning disability (as well as their families and supporters). We believe we must work with people with a learning disability to do this. We especially want people with a learning disability to work for us as staff and volunteers, and to be members of Mencap.

You can expect some things from Mencap.

  • You can expect not to be abused or bullied.
  • You can expect to be treated with respect – it should not matter how you look, whether you are a man or woman, what race you are, how old you are, your sexual orientation, if you are disabled or not, or anything else that makes

you different.

  • If you have a complaint, you can expect that we will deal with it quickly. We will not tell anyone who does not need to know.

Mencap expects some things from you.

  • You should not be rude to, bully or treat anyone at Mencap badly. This includes staff, people who use Mencap services, Mencap members and volunteers.
  • You should treat everyone with respect – it should not matter what they look like, whether they are a man or woman, what race they are, how old they are, their sexual orientation or whether they are disabled or not, or anything else that makes them different.
  • You should tell a manager in Mencap if you think something is happening that

is unfair.

Registered charity number 2223772007.428-05/08