Equality and diversity monitoring form for applicants

We invite you to complete this optional survey to help us evaluate our diversity and inclusion efforts. Submission of the information on this form is strictly voluntary and refusal to provide it will not subject you to any adverse treatment or affect your job application. Information obtained will be kept separate from your name or job application. This information will be kept secure and confidential and will be used solely to evaluate our diversity and inclusion efforts.

• Age
  • under 18
  • 18-24
  • 25-34
  • 35-44
  • 45-54
  • 55-64
  • 65 or older
  • Prefer not to say
• What is your ethnicity?
  • White/Caucasian
  • Black, African, Caribbean or Black British
  • Asian or Asian British
  • Mixed or Multiple ethnic groups
  • Other
  • Prefer not to say
• What gender do you identify as?
  • Female
  • Male
  • Non-binary
  • Intersex
  • Prefer not to say
• Is the gender you identify with the same as your gender registered at birth?
  • Yes
  • No
  • Prefer not to say
• What is your sexual orientation?
  • Heterosexual
  • Gay/Lesbian
  • Bisexual
  • Asexual
  • Pansexual
  • Undecided
  • Prefer not to say
• What is your religion/belief?
  • None
  • Atheist
  • Agnostic
  • Christian
  • Islam
  • Hinduism
  • Sikhism
  • Judaism
  • Buddhism
  • Taoism
  • Other
• Do you consider yourself to have a disability?

  The information in this form is for monitoring purposes only. If you believe you need a ‘reasonable adjustment’, then please raise this when invited for interview.

  • Yes
  • No
  • Prefer not to say
• 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