Monitoring Form

Equal Opportunities Monitoring Form Confidential

How information about you will be used You are requested to complete this information to enable us to monitor the effectiveness of our Corporate Equalities Strategy. This information will be used solely for monitoring purposes, will be treated as confidential and will be separated from the application form on receipt and before selection procedures commence.

Equinox seeks to be an equal opportunities employer and give a fair deal to people within every section of the community. We would be grateful if you could answer the following questions, which will be treated in a confidential manner so that we can monitor our progress towards that aim. They will not be referred to in considering your application, unless the nature of the post being applied for is deemed to be exempt from the Equality Act 2010.

Please place a tick in the boxes where applicable:

A White B Mixed British White and Black Caribbean Irish White and Black African Polish White and Asian Italian Any other Mixed Background Any other White background

C Asian or Asian British How would you describe your D Black or Black British Indian ethnic origin? Caribbean Pakistani African Bangladeshi Any other Black background Any other Asian background

E Chinese Chinese Any other ethnic group F Do not wish to disclose

Do you consider yourself to have a disability? Yes No

Male Female Gender Transgender Do not wish to disclose

Heterosexual Gay Bi-sexual Sexual orientation Lesbian Do not wish to disclose

Religious Beliefs: Do you consider your religious beliefs to be:

Church of Scotland Church of England Church of Ireland

Other Christian Catholic Free Church

Muslim Buddhist Hindu

Jewish Sikh Other Religion or Philosophy

Do not wish to disclose

The information you have provided (but your name) may be used to provide statistical analysis so that we can monitor our compliance with best practice in terms of equal opportunity and non-discrimination.