Marketing and Communications Officer equal opportunities monitoring form

Heritage Trust Network is an Equal Opportunities Employer. We do not discriminate against any group of job applicants or employees and we aim to select the best person for the job.

We monitor the characteristics of our job applicants in order to assess whether our recruitment methods are attracting a diverse range of candidates, to demonstrate our commitment to promoting equality of opportunity in employment and to comply with our duties under the law.

This form is anonymous and this information will be treated in the strictest of confidence and protected from misuse. It will be used only for the purpose of monitoring our success in attracting a diverse range of candidates.

What best describes your gender?

Female	Male
Prefer not to say	Prefer to self-describe...

Is your gender identity the same as the sex you were assigned at birth?

NoYesPrefer not to say

Age
Please give your date of birth (use the format (DD/MM/YYYY)

Disability
Do you consider yourself to have a disabilty?

YesNo

If you answered 'yes' please indicate the nature of your impairment:

Physical impairment, such as difficulty using your arms, or mobility issues requiring to use a wheelchair or crutchesSensory impairment, such as being blind or having a serious visual impairment, or being deaf or having a serious hearing impairmentMental health condition, such as depression or schizophreniaLearning disability or difficulty, such as Down's Syndrome or dyslexia, or Cognitive impairment such as autistic spectrum disorderLong standing or progressive illness or health condition, such as cancer, HIV infection, diabetes, epilepsy or chronic heart diseaseOther (please specify):

Language
Is English your first language?

Yes

Dependents
Do you have a personal responsibility for the care of a child or children, a person with a disability or a dependant older person?

Yes

How did you find out about this vacancy?

Contact Information

White	Black Caribbean	Black African	Black Other
Pakistani	Indian	Bangladeshi	Chinese
Other (or mixed) please specify:

Bi	Gay man	Gay woman/lesbian
Heterosexual/straight	Prefer not to say	Prefer to self-describe...