EQUAL OPPORTUNITIES MONITORING FORM
This equal opportunities monitoring form template is based on a free document supplied by The Legal Stop Limited through its website www.thelegalstop.co.uk
Technology Books for Children, in accordance with its Equal Opportunities Policy, undertakes to provide equal opportunities to all employees and job applicants and not to discriminate either directly or indirectly because of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race (including colour, nationality and ethnic or national origins), religion or belief, sex and/or sexual orientation.
All information provided on this form will be treated completely confidentially and will be used solely for the purpose of equal opportunities monitoring. This Equal Opportunities Monitoring Form does not form part of your job application and will therefore be detached from it on receipt and stored separately.
Thank you for your assistance in completing this form.
Name: | |||
Title of job applied for: | |||
Location of job: | |||
Gender: | Male | ||
Female | |||
Undergoing, or have undergone, male to female gender reassignment | |||
Undergoing, or have undergone, female to male gender reassignment | |||
Prefer not to say | |||
Marital status: | Married | ||
Single | |||
In a civil partnership | |||
Other (please specify) | |||
Prefer not to say | |||
Age band: | Under 18 | ||
18 – 21 | |||
22 – 30 | |||
31 – 40 | |||
41 – 50 | |||
51 – 60 | |||
61 – 65 | |||
Over 65 | |||
Prefer not to say | |||
Sexual orientation: | Heterosexual | ||
Homosexual | |||
Bisexual | |||
Transsexual | |||
Prefer not to say | |||
Disabilities: | None | ||
Physical disability (please specify) | |||
Mental disability (please specify) | |||
Prefer not to say | |||
Race/colour nationality/ ethnic origin: | White | English | |
Scottish | |||
Welsh | |||
Irish | |||
Other white background (please specify) | |||
Mixed | White and Black Caribbean | ||
White and Black African | |||
White and Black British | |||
White and Asian | |||
Other mixed background (please specify) | |||
Asian | Indian | ||
Pakistani | |||
Bangladeshi | |||
British | |||
Other Asian background (please specify) | |||
Black | Caribbean | ||
African | |||
British | |||
Other black background (please specify) | |||
Chinese | |||
Other ethnic group (please specify) | |||
Prefer not to say | |||
Religion: | Christian | ||
Catholic | |||
Jewish | |||
Sikh | |||
Muslim | |||
Hindu | |||
Buddhist | |||
Rastafarian | |||
None | |||
Other religion (please specify) | |||
Prefer not to say | |||
For the purposes of the Data Protection Act 1998, I hereby confirm that by completing this form I give my consent to the Company processing the data supplied on this form for the purpose of equal opportunities monitoring.
Signed:
……………………………
Date: