Equality Monitoring Form

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Viv Gordon Company collects equality information solely for monitoring purposes to ensure that our policies and procedures are effective. Our Equality Policy commits us to having a workforce that reflects all sections of society – the data you share will be used to monitor and evaluate if these obligations are met or not.

Viv Gordon Company is committed to the principles of fairness, consistency and equality of opportunity. No applicants will be discriminated against regardless of their age, colour, disability, ethnicity, gender or gender identity, race, religion or belief and / or sexual orientation or if you do not wish to complete this form.

The information you enter on this Equality and Diversity monitoring form will be used for monitoring purposes only and will not be used in assessing and or scoring your application or at interview stage. This information is kept fully confidential and accessibility is strictly limited in accordance with the Data Protection Act.

Thank you for taking the time to complete this equality monitoring form.

Whilst working with Viv Gordon Company are you: *

Freelance / Self-Employed Artist

Volunteer

Trainee

Participant

Sex or Gender Identity *

Male

Female

Prefer not to say

Other:

Do you consider yourself to be a trans person?
Trans is an umbrella term to describe people whose gender is not the same as the sex they were assigned at birth.
*

Yes

Prefer not to say

What age group do you belong to?

18-25

26-35

36-45

46-55

56-65

65+

Prefer not to say

Clear selection

How would you describe your sexuality? *

Heterosexual/Straight

Gay/Lesbian

Bi/bisexual

Prefer not to say

Other:

Do you consider yourself to have a disability?

The Equality Act 2010 protects people who are disabled including those with long-term health conditions.

Yes

Prefer not to say

Disability continued
If ‘Yes’ please state the type of impairment which applies to you. People may experience more than one type of impairment, in which case you may indicate more than one. If none of the categories apply, please mark ‘other’.

Physical Impairment

Sensory Impairment

Mental Health Needs

Learning Disability / Difficulty

Long term Health Condition

Other

Please indicate which ethnic group you consider yourself to belong to?

White – British (to include Northern Ireland, Scotland & Wales)

White – Irish

White - European

White - Other

Black or Black British – Caribbean

Black or Black British – African

Black - Other

Asian or Asian British – Indian

Asian or Asian British – Pakistani

Asian or Asian British – Bangladeshi

Chinese

Asian - Other

Mixed – White & Black Caribbean

Mixed – White & Black African

Mixed – White & Asian

Mixed - Other

Ethnic identity not known

Prefer not to say

Ethnicity : If you have selected ‘Other’ in the previous question, please state which group you consider yourself to belong to

Please indicate which religion you consider yourself to belong to?
*

Buddhist

Christian

Hindu

Jewish

Muslim

Sikh

No religion

Prefer not to say

Other:

Do you have caring responsibilities? *

No caring responsibilities

Primary carer of a child / children (under 18)

Primary carer of disabled child / children (under 18)

Primary carer of disabled adult (18 and over)

Primary carer of older person

Prefer not to say

Other:

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