The Donkey Sanctuary Works Proactively to Identify and Remove Any Barriers Encouraging

Equality and Diversity Monitoring Form

The Donkey Sanctuary works proactively to identify and remove any barriers encouraging equality and diversity in our employment opportunities.

The information you provide will enable The Donkey Sanctuary to monitor the effectiveness of its Equality and Diversity charter and help meet obligations under the Equality Act 2010.We need to monitor the community background of our employees, as required by the Fair Employment (NI) Order 1998.

Completing this form is voluntary and theinformation is only used for research and statistical analysis. The information contained in this formwill be treated as confidential and will be used for monitoring purposes. This form will be handled separately from your application and will not be used to assess your suitability for employment.

Please tickthe box below to confirm you have read and understood the Privacy Notice included with the application pack sent to you with this form.

I confirm that I have read and understood the Privacy Notice:

Please return the completed form in the envelope marked ‘Strictly confidential’ to Resourcing Department, The Donkey Sanctuary, Slade House Farm, Sidmouth. EX10 0NU or email your form to

First Name……………………………Surname…………………………………....
Role Applied for …………………… Date ………………………………………….
Gender:
Man Woman Prefer not to disclose
If you prefer to describe your gender in another way, please specify here ………………………………………………………………….………………………
Are you married or in a civil partnership?
Yes No Prefer not to disclose
Age16-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ Prefer not to disclose
What is your ethnicity?
Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong. Please tick the appropriate box
White
English Welsh Scottish Northern Irish Irish British
Gypsy or Irish Traveller Prefer not to disclose
Any other white background, please specify here…………………………
Mixed/multiple ethnic group
White and Black Caribbean White and Black African White and Asian
Prefer not to disclose
Any other mixed background, please specify here………………………
Asian/Asian British
Indian Pakistani Bangladeshi Chinese Prefer not to disclose
Any other Asian background, please specify here………………………
Black/ African/ Caribbean/ Black British
African Caribbean Prefer not to disclose
Any other Black/African/Caribbean background, please specify here………………………
Other ethnic group
Arab Prefer not to disclose
Any other ethnic group, please specify here………………………
Do you consider yourself to have a disability or health condition?
Yes No Prefer not to disclose
Please specify the nature of your disability………………………………
What is your sexual orientation?
Heterosexual Gay woman/lesbian Gay man Bisexual
Prefer not to disclose
If you prefer to describe your sexual orientation in another way, please specify here ………………………………………………………………….………………………
Perceived Religious Affiliation?
I am a member of the Roman Catholic community
I am a member of the Protestant community
I am a member of neither the Protestant or Roman Catholic community