Equal opportunities monitoring form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Hi, thanks for helping us out with this.

10:10 is committed to ensuring that no applicant receives less favourable treatment on any grounds not relevant to good employment practice, i.e. on the grounds of gender, race, age, ethnic origin, class, sexual orientation or marital status. In order to assist us in monitoring the effectiveness of our equal opportunities policy, we would appreciate it if you would answer the questions below.

The information provided will be treated in strict confidence and stored separately from your application. This information will not be used in short listing or interviewing. Completion of this form is voluntary and if you do not wish to answer any question(s), this will not affect your application in any way.

If you have any questions or concerns, please contact jobs@1010uk.org

How did you hear about this opportunity?

What's your gender?

Are you married or in a civil partnership?

Yes

Clear selection

How old are you?

16-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65+

Clear selection

What is your ethnicity? This question is about the group to which you perceive you belong, which might not be the same as your nationality or place of birth.

White - British, English, Welsh, Scottish, Northern Irish, Cornish

White - Irish

White - Other EU national

White - Other

Asian/Asian British - Indian

Asian/Asian British - Pakistani

Asian/Asian British - Bangladeshi

Asian/Asian British - Chinese

Asian/Asian British - Other

Black, African, Caribbean, or Black British - African

Black, African, Caribbean, or Black British - Caribbean

Mixed/multiple - White and Black African

Mixed/multiple - White and Asian

Mixed/multiple - Other or multiple ethnic background

Prefer not to say

Other:

Clear selection

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

What is your sexual orientation?

What is your religion or spiritual practice?

No religion or belief

Buddhist

Christian

Hindu

Jewish

Muslim

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)

Prefer not to say

Other:

Data protection

Information from this application will be processed by 10:10 for the purposes of monitoring diversity in our recruitment. You have, on request, the right of access to personal data held about you. We will hold your data securely, and anonymously. I hereby give my consent to 10:10 processing the data supplied in this form for the purpose of recruitment and selection.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Possible. Report Abuse

Forms