Equality Monitoring Form

This form is optional and can be completed anonymously.

Under the Equality Act 2010 people are protected from unlawful discrimination if they have the following protected characteristics; age, marriage and civil partnerships, race, religion and belief, sex, gender reassignment, sexual orientation, disability and pregnancy and maternity.
It is sensible to feel protective or cautious about disclosing any personal information, but feel assured that this information will be used for monitoring purposes only and not for any other purpose.

Name (Optional)

Post applied for?

Where did you hear about this post?

Date of Birth

What is your race? (this includes colour, nationality including citizenship, and ethnic or national origins)

What is your religion or belief? - please select as appropriate

What is your relationship status? - please select as appropriate

What is your sexual orientation?

Pregnancy and Maternity (the Equality Act 2010 protects women who are pregnant or have given birth within a 26 week period)

Are you pregnant at this time

Have you recently given birth (within 26 weeks)

Do you consider yourself to have a disability?

(The Equality Act 2010 states a person has a disability if they have a physical or mental impairment which has long term (12 month period) or substantial adverse effects on their ability to carry out day-to-day activities)