Position: PROJECT OFFICER - TRAINING Job reference: SAV1403

EQUAL OPPORTUNITIES POLICY - APPLICATION MONITORING CSV is committed to Equal Opportunities. To help us, applicants are asked to answer these questions by putting a tick in the appropriate box. This information is optional and will only be used for monitoring purposes. It will be treated as confidential. It will be separated from the application form on receipt and will not in any way influence the consideration of candidates. If you do not wish to disclose this information, please tick this box Information withheld. If you do not complete this questionnaire, we will still consider your application. If you decide not to provide this information, we would be grateful if you can complete Question 1 of this form.

Full Name: c. Asian or Asian British Indian Pakistani 1) How did you hear about the vacancy you have Bangladeshi applied for? Asian UK

CSV Bulletin (Internal) Asian Other [please state] Job Centre ______Guardian Newspaper d. Mixed Other Newspaper [please state] White & Black Caribbean White & Black African Charity Job Website White & Asian CSV Web Site Any Other Mixed Race [please state] Other Website [please state] ______

Recruitment Agency e. Chinese Other [please state] Or other Ethnic Group [please state] ______2) My sex is : Male 5) Do you have a disability or impairment? Female For guidance of what could be classed as a 3) My age is: 20 or under disability under the Equality Act 2010, please 21 – 25 see below: 26 – 30 Yes 31 – 40 No 41 – 50 51 – 60 As guidance, a disability under the Equality Act 2010 60 + is a physical or mental impairment which has a 4) I would describe my ethnic origin as: substantial and long-term adverse effect on your ability to carry out normal day-to-day activities. Some a. White British examples of what could be a disability under the English Equality Act 2010: are: Scottish Welsh  People with long-term health conditions, such White Other as diabetes, arthritis, asthma and epilepsy White Irish  People who have been diagnosed with White European progressive conditions, such as multiple White Other [please state] sclerosis, HIV and cancer  People with learning difficulties such as ______Down’s syndrome and severe dyslexia  People with mental health conditions such as b. Black or Black British depression and schizophrenia African  People who have mobility impairments Caribbean  Blind and partially-sighted people Black UK  Deaf and hearing-impaired people People Black Irish with physical impairments such as severe Black European scars, visible birthmarks and skin disease Black Other [please state] ______

237 Pentonville Road London N1 9NJ. T 020 7278 6601 F 020 7833 0149 www.csv.org.uk CSV creates opportunities for people to take an active part in the life of their community. CSV is a registered charity no. 291222 and is a company limited by guarantee registered in England under no. 1435877. 237 Pentonville Road London N1 9NJ. T 020 7278 6601 F 020 7833 0149 www.csv.org.uk CSV creates opportunities for people to take an active part in the life of their community. CSV is a registered charity no. 291222 and is a company limited by guarantee registered in England under no. 1435877.