Please Note That You Are Not Obliged to Complete This Form If You Do Not Wish To

RECRUITMENTMONITORINGFORM

We are committed toensuring that all job applicants and members of staff are treated equally, without discrimination because of gender, sexual orientation, marital or civil partner status, gender reassignment, race, colour, nationality, ethnic or national origin, religion or belief, disability or age. This form is intended to help us maintain equal opportunities best practice and identify barriers to workforce equality and diversity.

Please complete this form and return it with your application. The form will be separated from your application on receipt. All information on this form will be treated with the strictest of confidence and will not form part of the recruitment process. It will not be made available to those who are selecting candidates for interview.

Please note that you are not obliged to complete this form if you do not wish to.

Position applied for: / Today’s date: /

GENDERFemale☐Male☐Prefer not to say ☐

GENDER IDENTITYDo you identify as transgender / transsexual?

Yes☐No☐Prefer not to say ☐

AGE 16-17☐22-30☐41-50☐61-65☐71+☐

18-21☐31-40☐51-60☐66-70☐Prefer not to say☐

SEXUAL ORIENTATIONHeterosexual / Straight☐Bisexual ☐Prefer not to say ☐

Gay man☐Gay woman ☐

If you are lesbian, gay or bisexual, are you open about your sexual orientation?

Yes / Partially / No
At home / ☐ / ☐ / ☐ /
With colleagues / ☐ / ☐ / ☐ /
With your manager / ☐ / ☐ / ☐
At work generally / ☐ / ☐ / ☐

DISABILITYThe Equality Act 2010 defines a person as having a disabilityif 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. An effect is long-term if it has lasted, or is likely to last, more than 12 months.

Do youconsider that you have a disability under the Equality Act?Yes ☐No ☐Prefer not to say☐

RELIGIONPlease tick or describe your religion or other strongly held belief:

None☐Hindu☐

Christian (includes Church of England, Catholic,☐Muslim☐

Protestant and all other Christian denominations)☐Sikh☐

Buddhist☐Jewish☐

Ravidassia☐Any other religion☐

Other Prefer not to say☐

ETHNIC GROUP How would you describe your nationality and/or ethnicity?

WHITEBLACK OR BLACK BRITISH

British (English, Scottish, Welsh)☐Caribbean☐

Irish☐African☐

Any other White background☐Any other Black background☐

MIXEDWhite and Black Caribbean☐CHINESE OR OTHER ETHNIC GROUP

White and Black African☐Chinese☐

White and Asian☐Other☐

Any other mixed background☐Prefer not to say☐

ASIAN OR ASIAN BRITISHTRAVELLER (from a travelling community)☐

Indian☐

Pakistani☐

Bangladeshi☐

Any other Asian background☐

WHERE DID YOU SEE THIS POSITION ADVERTISED:

Times Educational Supplement☐The Tablet☐The Universe☐

Teachers’ TrainingCollege☐Agency☐Mercury☐

Herts& Essex Observer☐Star☐Word of mouth☐

Online☐Where seen:

Other☐Where seen:

Thank you for help in assisting us with our recruiting systems.
Please return this form to / Z:\VACANCIES
[21.10.16]
Page 1