<p> Equality and diversity monitoring form</p><p>Brightside is an organisation keen to ensure that all employees, volunteers and job applicants receive fair treatment in an environment which is free from any form of discrimination as outlined by the Equality Act 2010. We ask that you help us to do this by completing the below where possible and in whatever way you feel most comfortable. </p><p>The information you provide will stay confidential, be stored securely and limited to senior leaders and our administrator.</p><p>Applicant Information</p><p>Full Name: Surname First Name Initial Address: Street Address</p><p>Town/City County Postcode Home Phone No: ( ) Email Address:</p><p>Position Applied for:</p><p>Do you have the right to work in the UK? Yes/No</p><p>Diversity Monitoring Form</p><p>Brightside is an equal opportunities employer. Everyone who is eligible to join Brightside will receive equal treatment when applying for jobs whatever their background. The information provided will be used to monitor the recruitment process only and the information will be treated in confidence. The information will not in any way affect your job application. You are not obliged to fill out the Diversity Form</p><p>How did you hear about this position?</p><p>Charityjob.co.uk Word of Mouth</p><p>Jobs.ac.uk Careers Office Brightside Website</p><p>Other</p><p>If other, please give details: </p><p>Gender:</p><p>☐Male ☐ Female ☐Prefer not to say Age range:</p><p>☐18-24 ☐25-29 ☐30-34 ☐ 35-39 ☐40-44 ☐45-49 ☐50-54 ☐55-59 ☐60-64 ☐65+ ☐Prefer not to say</p><p>Race or Ethnic Origin ☐ Black African Black Caribbean Black Other</p><p>Indian Pakistani Bangladeshi</p><p>Asian Other White Irish Traveller of Irish Heritage</p><p>Gyspy/Roma White British White Other</p><p>Chinese Black Caribbean/White Black African/White</p><p>Asian/White Chinese/White Mixed Race Other</p><p>Any Other Ethnic Origin (Please specify if you wish)</p><p>I do not wish to specify an ethnic origin</p><p>Do you consider yourself to have a disability or health condition? </p><p>Yes  No  Prefer not to say </p><p>If you have answered yes above, is there anything we should have in place in order to make the interview process more accessible for you? Please detail below:</p><p>______</p><p>______</p><p>Data Protection Statement</p><p>The information which you give will be used for the following purposes: to enable the Brightside to create a record of your application; to enable the application to be processed, and to enable Brightside to compile statistics. No statistical information that would identify you as an individual will be published. The information will be kept securely, and will be kept no longer than necessary.</p><p>Declaration</p><p>I have checked these details are correct. I understand and agree to Brightside using this data to create and maintain records on me for statistical purposes in accordance with the Data Protection Act 1998. I agree that this information will be kept for the duration of the recruitment process and for a period of time thereafter. Should I be employed I agree that this information will be kept for the duration of my employment and for a period of time following this. I am aware I have the right to request a copy of the data held on me.</p><p>Signature: Date: </p>