Equal Opportunities Monitoring Form printable pdf download

Equal Opportunities Monitoring Form

Moat has an equality & diversity policy to ensure that all applicants are considered solely on their merits on

abilities. We therefore welcome applicants from all sections of the community regardless of gender, age,

marital status, ethnic origin, religion, disability or sexual orientation. All stages of the recruitment process

are monitored to check that unfair discrimination is not taking place. We would therefore like you to answer

the following questions. The information will not be used as part of the selection process.

If you are completing this form electronically, press the [TAB] key to move to the next field. The

form will expand automatically as necessary.

General Information

Name:

Date applied:

Role applied for:

Gender:

PLEASE CHOOSE

Age Group:

PLEASE CHOOSE

Marital Status:

PLEASE CHOOSE

If other please specify:

Ethnic Origin

Ethnic origin is not about nationality, place of birth or citizenship. It is about colour and broad ethnic group.

UK citizens can belong to any of the groups indicated. Please choose the category which you feel most

closely describes your ethnic origin.

Ethnic Origin:

PLEASE CHOOSE

Religion

Religion:

PLEASE CHOOSE

If other please specify:

Disability

A disability regarded as a physical or mental impairment which has a substantial and long term adverse

affect on a person’s ability to carry out day to day activities.

Do you consider yourself to have a

Yes

Refused

disability or disabling condition?:

If yes, please specify:

PLEASE CHOOSE

Sexual Orientation

I would describe myself as:

PLEASE CHOOSE

Data Protection Act 1998

The information you have provided will be used by Moat to create or update records held by us. Your

information will be processed in accordance with the Data Protection Act 1998. This is to help us to meet

our legal obligations and to ensure all recruitment candidates are treated fairly. You are entitled to a copy

of the information we hold about you by writing to us and requesting it. As the information you have

provided contains sensitive personal data, you are required to expressly consent to our processing of such

data in the way described above.

If you agree to have your information used in this way, please check the box

Moat: A charitable housing association

Equal Opportunities Monitoring Form

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