Equal Opportunities Form

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Julie’s Bicycle wants to meet the aims and commitments set out in its equality 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.

The organisation needs your help and co-operation to enable it to do this, but filling in this form is voluntary.

The information you provide will stay confidential, and be stored securely and limited to only some staff in the organisation’s Human Resources section.

Email *

Gender *

Man

Woman

Non-binary

Prefer not say

Other:

Are you:

Cisgender

Transgender

Prefer not say

Other:

Clear selection

Are you married or in a civil partnership?

Yes

Prefer not to say

Other:

Clear selection

Age:

16 - 24

25 - 29

30 - 34

35 - 39

40 - 44

45 - 49

50 - 54

55 - 59

60 - 64

65 +

Prefer not to say

Clear selection

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.

White English

White Welsh

White Scottish

White Irish

White European

White - other background

Mixed/multiple ethnic groups - White and Black Caribbean

Mixed/multiple ethnic groups - White and Black African

Mixed/multiple ethnic groups - White and Asian

Mixed/multiple ethnic groups - other background

Asian/Asian British - Indian

Asian/Asian British - Bangladeshi

Asian/Asian British - Pakistani

Asian/Asian British - Chinese

Asian/Asian British - other background

Black / African

Black / Caribbean

Black / British

Black / other background

Other ethnic group / Arab

Other ethnic group / GRT Communities

Other ethnic group / other background

Prefer not to say

Other:

Clear selection

Do you consider yourself to have a disability or health condition?

Yes

Prefer not to say

Other:

Clear selection

If yes, please describe the nature of your disability:

The information in this form is for monitoring purposes only. If you need a reasonable adjustment, then please email recruitment@juliesbicycle.com to discuss your needs.

What is your sexual orientation?

Heterosexual

Gay woman/lesbian

Gay man

Bisexual

Prefer not to say

Other:

Clear selection

What is your religion or belief?

No religion or belief

Buddhist

Hindu

Christian

Muslim

Jewish

Sikh

Prefer not to say

Other:

Clear selection

Do you have caring responsibilities? If yes, please tick all that apply

None

Primary carer of a child/children (under 18)

Primary carer of disabled child/children

Primary carer of disabled adult (18 and over)

Primary carer of older person

Secondary carer (another person carries out the main caring role)

Option 7

Prefer not to say

Other:

Please tell us where you saw this vacancy advertised?

Submit

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