Equality and diversity monitoring form - Youth engagement worker recruitment

AYPH wants to meet the aims and commitments set out in its equal opportunities policy. This includes not discriminating under the Equality Act 2010, and building an accurate picture of the make-up of the workforce in encouraging equality and diversity.

The organisation needs your help and co-operation to enable it to do this, but filling in this form is voluntary.

The information you provide will stay confidential, and be stored securely and limited to only some staff in the organisation’s Human Resources section.

If you have any questions about this form please contact info@ayph.org.uk

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* 1. What gender are you?

Female

Male

Intersex

Non-binary

Prefer not to say

If you prefer to use your own term, please specify

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* 2. Are you married or in a civil partnership?

Yes

Prefer not to say

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* 3. How old are you?

16-24

25-34

35-44

45-54

55-64

65+

Prefer not to say

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* 4. What is your ethnicity?

Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong.

	White / White British	Black / Black British	Mixed / multiple ethic groups	Asian / Asian British	Other ethnic backgrounds	Prefer not to say
Please scroll along and tick the appropriate box	Please scroll along and tick the appropriate box White / White British menu	Please scroll along and tick the appropriate box Black / Black British menu	Please scroll along and tick the appropriate box Mixed / multiple ethic groups menu	Please scroll along and tick the appropriate box Asian / Asian British menu	Please scroll along and tick the appropriate box Other ethnic backgrounds menu	Please scroll along and tick the appropriate box Prefer not to say menu

Any other ethnic group, please write in:

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* 5. Do you consider yourself to have a disability or health condition?

The Disability Discrimination Act 1995 (DDA) defines a person as disabled if they have a physical or mental impairment, which has a substantial and long term effect (i.e. has lasted or is expected to last at least 12 months) on the person’s ability to carry out normal day-to-day activities. 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.

Yes

prefer not to say

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* 6. What is your sexual orientation?

As people are discriminated against because of their sexual orientation, we believe that it is helpful to gather this information. We appreciate that you may not wish to answer this question however - in which case please tick the ‘Prefer not to say’ box.

Heterosexual

Gay woman / lesbian

Gay man

Bisexual

Prefer not to say

If other, please write in

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* 7. What is your religion or belief?

No religion or belief

Buddhist

Christian

Hindu

Jewish

Muslim

Sikh

Prefer not to say

If other religion or belief, please state

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* 8. What is your current working pattern?

Full-time

Part-time

Prefer not to say

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* 9. What is your flexible working arrangement?

None

Flexi-time

Staggered hours

Term-time hours

Annualised hours

Job-share

Flexible shifts

Compressed hours

Homeworking

Prefer not to say

Other (please specify)

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* 10. 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)

Other (please specify)

Equality and diversity monitoring form - Youth engagement worker recruitment

Question Title

* 1. What gender are you?

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* 2. Are you married or in a civil partnership?

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* 3. How old are you?

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* 4. What is your ethnicity?Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong.

Question Title

Question Title

* 6. What is your sexual orientation?As people are discriminated against because of their sexual orientation, we believe that it is helpful to gather this information. We appreciate that you may not wish to answer this question however - in which case please tick the ‘Prefer not to say’ box.

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* 7. What is your religion or belief?

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* 8. What is your current working pattern?

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* 9. What is your flexible working arrangement?

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* 10. Do you have caring responsibilities? If yes, please tick all that apply

* 4. What is your ethnicity?

Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong.

* 6. What is your sexual orientation?

As people are discriminated against because of their sexual orientation, we believe that it is helpful to gather this information. We appreciate that you may not wish to answer this question however - in which case please tick the ‘Prefer not to say’ box.