Equality and Diversity Monitoring Form

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Highlights 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.

Highlights needs your help and co-operation to enable it to do this, but filling in this form is voluntary. The information provided will be kept confidential and will be used for monitoring purposes.

If you have any questions about the form contact info@highlightsnorth.co.uk

What Role are you applying for?

Gender

Female

Male

Intersex

Non-binary

Prefer not to say

Clear selection

Is the gender you identify with the same as your gender registered at birth?

Yes

Prefer not to say

Clear selection

What is your ethnicity?

Asian or Asian British - Indian

Asian or Asian British - Pakistani

Asian or Asian British - Bangladeshi

Asian or Asian British - Chinese

Asian or Asian British - Any other Asian background

Asian or Asian British - Prefer not to say

Black, African, Caribbean or Black British - African

Black, African, Caribbean or Black British - Caribbean

Black, African, Caribbean or Black British - Any other Black, African, Caribbean or Black British background

Black, African, Caribbean or Black British - prefer not to say

Mixed or Multiple ethnic groups - White and Black Caribbean

Mixed or Multiple ethnic groups - White and Black African

Mixed or Multiple ethnic groups - White and Asian

Mixed or Multiple ethnic groups - Any other Mixed or Multiple ethnic background

Mixed or Multiple ethnic groups - Prefer not to say

White - English

White - Welsh

White - Scottish

White - Northern Irish

White - British

White - Gypsy or Irish Traveller

White - Any other White background

White - Prefer not to say

Other ethnic group - Arab

Other ethnic group - prefer not to say

Prefer not to say

Clear selection

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

Yes

Prefer not to say

Clear selection

What is the effect or impact of your disability or health condition on your work? (This information is for monitoring purposes only, if you believe you need a 'reasonable' adjustment, then please discuss this with us.

What is your sexual orientation?

Heterosexual

Gay

Lesbian

Bisexual

Asexual

Pansexual

Undecided

Prefer not to say

Clear selection

What is your religion or belief?

No religion or belief

Buddhist

Christian

Hindu

Jewish

Muslim

Sikh

Other

Prefer not to say

Clear selection

Do you have caring responsibilities?

None

Primary carer of a child/children (under 18)

Primary carer of a disabled child/children

Primary carer of a disabled adult (18 and over)

Primary carer of older person

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

Prefer not to say

Clear selection

Submit

Clear form

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