Equal Opportunity Form

EQUAL OPPORTUNITIES MONITORING

CONFIDENTIAL

ACCD is committed to equal opportunities for all, irrespective of race, colour, creed, ethnic or national origins, gender, marital status, sexuality, disability or age.

We are committed to take positive action to promote such equality of opportunity and our recruitment, training and promotion procedures are based on the requirements of a job.

In order that we can monitor the implementation of our policy we are seeking your help. It would be of great assistance in pursuing our commitment to equal opportunities if you would indicate below your gender, ethnic origin, age and disability status by ticking the relevant boxes.

Completion of this form is voluntary.

                                                      M a l e                       Female

White                                                   [      ]                                        [       ]

Black Caribbean                                   [      ]                                       [       ]

Black African                                       [       ]                                       [       ]

Black (other)                                        [       ]                                       [       ]

Indian                                                  [       ]                                       [       ]

Pakistani                                              [       ]                                       [       ]

Bangladesh                                           [       ]                                       [       ]

Chinese                                                 [       ]                                       [       ]

Other*                                                  [       ]                                       [       ]

*Please specify ______________________________________________________

How old are you?          [        ]      [         ]       [          ]      [          ]      [          ]
                                      16 -24         25 -35       36 – 45       46 – 54        54 - 60

Do you have a disability?                       [         ] YES                         [       ] NO

This information will be treated in the strictest confidence and will be used only for statistical monitoring.  It is not part of the selection process.

Back to Policies