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Equal Opportunities Monitoring form

Equal Opportunities Monitoring

LEVEL is committed to recruiting, retaining and developing a workforce that reflects the diverse communities that we serve. We make sure that all existing and prospective members of staff are treated in a fair and equal manner regardless of the employee’s age, disability, gender identity, race, religion or belief, sex or sexual orientation.

Ethnicity

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

WhiteBritishIrishWelshScottishNorthern IrishEnglishGypsy or Irish TravellerPrefer not to sayOther

Mixed/multiple ethnic groupsWhite and Black CarribeanWhite and Black AfricanWhite and AsianPrefer not to sayOther

Asian/Asian BritishIndianPakistaniBangladeshiChinesePrefer not to sayOther

Black/African/Caribbean/Black BritishAfricanCaribbeanPrefer not to sayOther

Other ethnic groupArabPrefer not to sayOther

Gender

Please tick the appropriate box:

MaleFemaleNon-binaryIntersexTransPrefer not to sayPrefer to self-describe

Age

Please tick the appropriate box:

Under 2020 - 3435 - 4950 - 6465 and overPrefer not to say

Disability Status

Disability is defined by the Equality Act 2010 as a physical or mental impairment that has a substantial and long-term adverse effect on someone’s ability to carry out normal day-to-day activities. If you believe you need a ‘reasonable adjustment’, then please discuss this during your interview if shortlisted.

Do you consider yourself to have a disability or health condition? Please tick the appropriate box:YesNoPrefer not to say

Sexual Orientation

Please tick the appropriate box

HeterosexualGayLesbianBisexualprefer to self-describePrefer not to say

How we use your data

Information will only be used for statistical analysis. No data will be published or used in a way that allows an individual to be identified. All data will be retained for a period of 6 months and then destroyed. The information provided on this form will be treated in the strictest confidence. We would like your help by completing this form, but it is an optional part of the recruitment process. By completing and submitting this form you agree for your personal data to be used for the purposes stated above.

GDPR *I have read and understood LEVEL's privacy policy

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Rowsley
Derbyshire
DE4 2EL
01629 734848
Company Number: 06323704
Charity Number: 1124419

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