Acaswantstolive up to the standards set out in its Equality and Diversity policy and to meet its legal obligations
in respect of age, disability, gender, race or ethnic origin, religion or belief and sexual orientation.
We need your help and co-operation to enable us to do this. By providing this information you are helping us to ensure that our policies and practices do not discriminate.
The information you provide will be treated in the strictest confidence, it will be separated from your application form and interviewers and assessors will only have access to your Competency Examples.
Please select your ageband
16 - 21 / 31-40 / 51 - 59 / Over 65
22 - 30 / 41- 50 / 60 - 65 / Prefer not to say
Do you consider yourself to have a disability or health condition?
Yes / No / Prefer not to say
What is the effect or impact of your disability or health condition
on your ability to give of your best at work? ______
______
Please describe your gender
Male / Female
Other / Prefer not to say
Do you identify as transgender (an individual who wants to change their gender to the opposite of that they were assigned at birth)?
Yes / No / Prefer not to say
What is your religion or belief?
Buddhist / Muslim
Christian / No religion or belief
Hindu / Sikh
Jewish / Prefer not to say
Other religion or belief, please write in: ______
What is your sexual orientation?
Bisexual (attracted to people of the same and
the opposite sex) / Lesbian (woman
attracted to other women)
Gay (man attracted to other men) / Prefer not to say
Heterosexual(attracted to people of the opposite sex)
Other, please write in: ______
What is your ethnic group?
A. Asian or Asian British / A. White
Bangladeshi
Indian
Pakistani
Prefer not to say
Any other Asian background, please write in:
______
B. Black or Black British
African
Caribbean
Prefer not to say
Any other Black background, please write in:
______
C. Chinese
Chinese
Prefer not to say
Any otherChinese background, please write in: ______
D. Mixed Heritage
White and Asian
White and Black African
White and Black Caribbean
Prefer not to say
Any other Mixed background, please write in:
______
E. White
British
English
Irish
Scottish
Welsh
Prefer not to say
Any other White background, please write in:
______
F. I do not wish to disclose my ethnic group
Vacancy Reference number: 1456910