Equality and Diversity Monitoring Form s3

EQUALITY AND DIVERSITY MONITORING FORM

The London Academy of Music & Dramatic Art is committed to equality of opportunity. The Academy recognises the value of what a diverse workforce can bring. To assist us to monitor the effectiveness of our equality and diversity practices, we would encourage you to complete this monitoring form. Please note that this form will be separated from your application prior to the selection process. The information you provide will be treated as sensitive data under the Data Protection Act 1998.

Please tick [] the relevant box in each section, or complete details as appropriate.

APPLICANT’S NAME: ______

POSITION APPLIED FOR: ______

Gender Male Female

Do you currently or have you previously Yes No Choose not to considered yourself as transgender? disclose

Age Years Months

Choose not to disclose

Do you consider yourself to have Yes No Unsure a disability?

Please state the type of disability which applies to you. People may experience more than one type of disability, in which case you may indicate more than one. If none of the categories apply, please mark ‘other’.

Physical impairment such as affecting your mobility which makes you requiring use of wheel chair 

Sensory impairment such as being blind or deaf 

Mental health condition such as depression or schizophrenia 

Learning Disability / Difficulty such as dyslexia or autism 

Long standing illness such as cancer, HIV, chronic heart disease or epilepsy 

Any other 

Human Resources Equality and Diversity Monitoring Form 1 Ethnic and Cultural Origin Please choose one section A to E, then tick the appropriate box or give details to indicate your cultural background A. White Scottish English Welsh Irish Other White Other White British (Please Background (Please state) state)

B. Mixed Any mixed background (Please state)

C. Asian, Asian Scottish, Asian English, Asian Welsh, Asian Irish or other Asian British

Indian Pakistani Bangladeshi Chinese Any other Asian background (Please state)

D. Black, Black Scottish, Black English, Black Welsh, Black Irish or other Black British

Caribbean African Other Black Background Black British (Please state)

E. Other ethnic background

Any other Background (Please state)

F. Other ethnic background

Choose not to disclose

Religion or Belief Christian

Buddhist Hindu Muslim Jewish Sikh

Other (Please state) Spiritual

No Religion or Belief Choose not to disclose

Sexual Orientation

Choose not to Bisexual Gay/Lesbian Heterosexual disclose

Human Resources Equality and Diversity Monitoring Form 2