equal opportunities monitoring form age disability gender
EQUAL OPPORTUNITIES MONITORING FORM Manchester Communication Academy (MCA) seeks to become an exemplar employer and make sure our processes and practices are fair to all applicants This form helps the Academy to monitor who is applying for jobs at MCA and the final selection decision made by the recruitment panel. We will use the information to assess and measure whether equality of opportunity is being achieved. The information on the form will be treated as strictly confidential but not anonymous.
AGE What is your age? 16 - 21
51 – 60
22 – 30
61 – 65
31 – 40
65 +
41 - 50
Prefer not to say
DISABILITY Many people who do not consider themselves disabled may be covered by the Equality Act 2010 because they have a health condition that has an impact on their lives. What do we mean when we say disability? Do you have a mental or physical impairment? Is it long term? Does this make it difficult for you to do things that most people do on a fairly regular or frequent basis? Do you consider yourself to have a disability, or a long term health condition?
Yes No Prefer not to say
GENDER Would you describe yourself as: Female Male Prefer not to say
RECRUITMENT / Equal Ops Monitoring Form / February 2014 / Page 1 of 3
ETHNIC ORIGIN These categories are not about nationality, place of birth or citizenship. They relate to broad ethnic groups. When you have read them all, please tick the box that most accurately describes the group to which you as an individual perceive you belong: ARAB OR MIDDLE EASTERN DESCENT
Arab Iraqi Kurdish North African Any other Middle Eastern background
ASIAN OR ASIAN BRITISH
Bangladeshi Indian Pakistani Other Asian background
BLACK OR BLACK BRITISH
African Caribbean Other Black background
CHINESE OR OTHER ETHNIC GROUP
Chinese Any other
WHITE
British Irish Any Other White background
MIXED
White and Black African White and Asian White and Black Caribbean Any other mixed background
PREFER NOT TO SAY
RECRUITMENT / Equal Ops Monitoring Form / February 2014 / Page 2 of 3
RELIGION Below is a list of religions that are most commonly found in Britain. They are in alphabetical order. We acknowledge this list is not exhaustive. Please tick the box that best describes you: Buddhist
Sikh
Christian
Other Religion or belief
Hindu
No Religion
Jew
Prefer not to say
Muslim
SEXUAL ORIENTATION What is your sexual orientation? Bisexual
Heterosexual / straight
Gay man
Other
Gay woman / lesbian
Prefer not to say
RECRUITMENT / Equal Ops Monitoring Form / February 2014 / Page 3 of 3
AGE What is your age? 16 - 21
51 – 60
22 – 30
61 – 65
31 – 40
65 +
41 - 50
Prefer not to say
DISABILITY Many people who do not consider themselves disabled may be covered by the Equality Act 2010 because they have a health condition that has an impact on their lives. What do we mean when we say disability? Do you have a mental or physical impairment? Is it long term? Does this make it difficult for you to do things that most people do on a fairly regular or frequent basis? Do you consider yourself to have a disability, or a long term health condition?
Yes No Prefer not to say
GENDER Would you describe yourself as: Female Male Prefer not to say
RECRUITMENT / Equal Ops Monitoring Form / February 2014 / Page 1 of 3
ETHNIC ORIGIN These categories are not about nationality, place of birth or citizenship. They relate to broad ethnic groups. When you have read them all, please tick the box that most accurately describes the group to which you as an individual perceive you belong: ARAB OR MIDDLE EASTERN DESCENT
Arab Iraqi Kurdish North African Any other Middle Eastern background
ASIAN OR ASIAN BRITISH
Bangladeshi Indian Pakistani Other Asian background
BLACK OR BLACK BRITISH
African Caribbean Other Black background
CHINESE OR OTHER ETHNIC GROUP
Chinese Any other
WHITE
British Irish Any Other White background
MIXED
White and Black African White and Asian White and Black Caribbean Any other mixed background
PREFER NOT TO SAY
RECRUITMENT / Equal Ops Monitoring Form / February 2014 / Page 2 of 3
RELIGION Below is a list of religions that are most commonly found in Britain. They are in alphabetical order. We acknowledge this list is not exhaustive. Please tick the box that best describes you: Buddhist
Sikh
Christian
Other Religion or belief
Hindu
No Religion
Jew
Prefer not to say
Muslim
SEXUAL ORIENTATION What is your sexual orientation? Bisexual
Heterosexual / straight
Gay man
Other
Gay woman / lesbian
Prefer not to say
RECRUITMENT / Equal Ops Monitoring Form / February 2014 / Page 3 of 3
