Omnia Learning Trust Equal Opportunities Monitoring Form

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The Omnia Learning Trust wants to meet the aims and commitments as 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.

We want to ensure that our recruitment processes are fair to all and allow us to attract diverse and talented candidates. The organisation needs your help and co-operation to enable it to do this but filling in this form is voluntary. You can select “prefer not to say” if you would rather not answer any question.

The information will not be used as part of the selection process; will not be seen by the interview panel and will only be used by Omnia Learning Trust for statistical purposes. No information will be published which allows any individual to be identified. The form should only take a few minutes to complete

What is your job title or which post are you applying for?

What is your name?

Where do you work or which school are you applying to? *

Central Trust

Didcot Primary Academy

Sires Hill

Twickenham Primary Academy

Wantage Primary Academy

What is your gender? *

Male

Female

Intersex

Non-binary

Prefer not to say

If you prefer to use your own gender identity, please write in below:

Do you have any physical or mental health conditions or illnesses lasting or expected to last 12 months or more? *

Yes

Prefer not to say

If you have answered yes to the previous question, does your condition or illness/do any of your conditions or illnesses reduce your ability to carry out day to day activities?

Yes, a lot

Yes, a little

Prefer not to say

Clear selection

Please choose one of the following options that most accurately describes your ethnic group or background. *

English/Welsh/Scottish/Northern Irish/British

Irish

Gypsy or Irish Traveller

Any other White background

White and Black Caribbean

White and Black African

White and Asian

Any other mixed/multiple ethnic background

Indian

Pakistani

Bangladeshi

Chinese

Any other Asian background

African

Caribbean

Any other Black/African/Caribbean background

Arab

Any other ethnic group

Prefer not to say

If you have selected one of the "any other background" options, please write it below

Which age bracket do you fall into? *

16 to 24

25 to 34

35 to 44

45 to 54

55 and over

Prefer not to say

Sexual Orientation *

Bisexual

Gay or lesbian

Heterosexual

Other

Prefer not to say

Religion or belief *

Budhist

Christian

Hindu

Jewish

Muslim

Sikh

Other

No religion

Atheist

Prefer not to say

Do you have any 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

Required

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