Achates Equality, diversity and Inclusion monitoring form
Achates wants to meet the aims and commitments set out in its Equality Opportunities, Diversity and Dignity at Work Policy . This includes not discriminating under the Equality Act 2010 and building an accurate picture of the make-up of the workforce in encouraging equality and diversity. If there are differences, it will enable us to take action to ensure that no group is treated unfairly. This form is reviewed by Achates' Director and General Manager only and only generalised data is shared with division heads.

Achates needs your help and co-operation to enable it to do this but filling in this form is voluntary.
Your answers will be treated confidentially.

Any accessibility requirements including reasonable adjustments necessary for any protected characteristics will be considered at the interview stage.
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Email *
Where did you hear of the vacancy? *
Gender *
Age *
What is your ethnicity? Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong. *
Disability
In the Equality Act 2010, a person has a disability if:

· they have a physical or mental impairment

· the impairment has a substantial and long-term adverse effect on their ability to perform normal day-to-day activities

For the purposes of the Act, these words have the following meanings:

· 'substantial' means more than minor or trivial

· 'long-term' means that the effect of the impairment has lasted or is likely to last for at least twelve months (there are special rules covering recurring or fluctuating conditions)

· 'normal day-to-day activities' include everyday things like eating, washing, walking and going shopping

- they have been diagnosed with HIV, cancer, or multiple sclerosis.
Do you consider yourself to have a disability or health condition under the Equality Act 2010?   *
Please describe the nature of your disability (if you wish).
What is the effect or impact of your disability or health condition on your ability to give your best at work? The information in this form is for monitoring purposes only. If you believe you need a ‘reasonable adjustment’, then please discuss this with your manager, or the manager running the recruitment process if you are a job applicant.
What is your sexual orientation? *
What is your religion or belief? *
Socio-economic Background
Although socio-economic background is not a protected characteristic under the Equality Act 2010, understanding social mobility and the social and economic background of the workforce is considered key in helping to form an accurate picture of how open and accessible we are.
Are you married or in a civil partnership? *
What type of school did you mainly attend between the ages of 11 and 16? *
Please think about the parent or other care-giver who was the highest income earner in your house when you were around 14 years old. What kind of work did they do? If this question does not apply to you (because for example, you were in care at this time), you can indicate this below. *
Where do you currently live? *
What is your current UK postcode? (if applicable) *
In which area of the UK did you predominantly grow up? *
Do you have caring responsibilities? *
Are you returning to work following an extended period (12 months or more) of absence? *
In the past 12 months, what has been your employment status for the majority of that time? *
Final check, have you? *
Required
Do you have any additional needs or access requirement not covered here or any additional comments?
Thank you for completing this form.
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