Hijinx Recruitment - Equal Opportunities Monitoring Form (English)

1. Introduction

Our company recognises and actively promotes the benefits of a diverse workforce and is committed to treating all employees with dignity and respect.

In accordance with our equal opportunities policy, our company will provide equality of opportunity to all employees and job applicants and will not discriminate either directly or indirectly on the grounds of race, sex, gender identity, marital status, disability, sexual orientation, religion/belief or age.

Please complete all sections. 
 
 

1. What age are you? *

 

2. What best describes your gender? *

 

3. Is your gender identity the same sex you were assigned at birth? *

 

4. Are you Married or in a Civil Partnership?

 

5. Sexual Orientation: Please tick against one of the following

 

6. Religion or belief: Please tick against one of the following

 

7. Asian / Asian British Ethnic Origin: Please tick against one of the following, only if applicable.

 

8. Black/African/Caribbean/ Black British Ethnic Origin:  Please tick against one of the following, only if applicable.

 

9. Mixed/ Multiple Ethnic Groups: Please tick against one of the following, only if applicable.

 

10. Other Ethnic Group: Please tick against one of the following, only if applicable. 

 

11. White Ethnic Origin: Please tick against one of the following, only if applicable.

 

12. I'd prefer not to say my ethnic origin : Please tick 'yes' below if this applies to you

 

13. Disability:

Do you consider yourself to have a disability?

You’re disabled under the Equality Act 2010 if you have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities. Conditions covered may include, for example, severe depression, dyslexia, diabetes, epilepsy and arthritis.

PLEASE NOTE: This information is provided for monitoring purposes only – if you need reasonable adjustments you should arrange these separately.

Please tick against one of the following:
  *

 

14. Do you have caring responsibilities? If yes, please tick all that apply:

Check out our survey templates or create your own.