DC-018 Equal Opportunities Monitoring Form


1.1 The information supplied on this form will be used in total confidence and in accordance with current Data Protection Legislation. It will help to ensure that the service properly monitors and conforms with its policies relating to the equality of opportunity.

1.2 Information will be used for monitoring and for no other purpose.

2.0 AIM

2.1 Our committed aim is to allow our support staff to develop their skills and realise their maximum potential as individuals without any wish on the part of the service to limit their opportunities.
Gender *
Are you married or in a civil partnership? *
Age *


3.1 Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong. Please tick the appropriate box:
Mixed/multiple ethnic groups
Asian/Asian British
Black/African/Caribbean/Black British
Other ethnic group
Do you consider yourself to have a disability or health condition? *
The information in this form is for monitoring purposes only. If you believe you need a ‘reasonable adjustment’, then please discuss this with your manager, or the manager running the recruitment process if you are a job applicant.
What is your sexual orientation? *
What is your religion or belief? *
What is your current working pattern? *
What is your flexible working arrangement? *
Do you have caring responsibilities? If yes, please tick all that apply *