Scottish Refugee Council

Equal Opportunities Monitoring Form

Scottish Refugee Council is committed to ensuring equality of opportunity in its recruitment and employment practices. To help us identify possible inequalities and barriers to employment we would appreciate your co-operation by completing this form.

The information provided will not influence any part of the selection process and will not be shared with the interview panel. All information you disclose will be treated confidentially and will only be used for statistical and monitoring purposes. Should you choose not to provide the details, the success of your application will not be affected. Scottish Refugee Council has a diverse workforce and we are committed to ensuring that our staff reflect the communities we serve.

1.Name ...... 2. Date of Birth …………………………….

3.Gender …………………………….. 4. Marital Status …………………………...

5.Disability

The Disability Discrimination At 1995 (DDA) protects disabled people. The Act defines a person as disabled if they have a physical or mental impairment, which is substantial and long-term (i.e. has lasted or is expected to last at least 12 months) and has an adverse effect on the person’s ability to carry out normal day to day activities.

Do you consider yourself to have a disability as defined in the DDA? Yes / No

If yes, are there any considerations in relation to this that we should take into account for making interview or assessment arrangements? …………………………………………………………………………………………………………………

6.Are you a refugee, or former refugeeYes/No

7.How would you describe your ethnic origin?

WhiteAsian, Asian Scottish or Asian British

 Scottish Indian

 Other British Pakistani

 Irish Bangladeshi

 Other white background, please specify: Chinese

 Any other Asian background, please specify:

Black, Black Scottish or Black BritishOther ethnic group

 Caribbean Any other background, please specify

 African

 Any other black background, please specify:

Mixed

 White and Black Caribbean

 White and Black African

 White and Asian

 Any other mixed background, please specify:

Thank you for taking the time to complete this form.