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Confidential

Equality and Diversity

The Northam Care Trust wants to meet the aims and commitments set out in its equality 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 cooperation to enable it to do this, but filling in this form is voluntary.
Please complete the form below - your answers are strictly confidential and are anonymous to us.

Gender:
Are you married or in a civil partnership?
Age

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.

Please click the appropriate box

White
Mixed/multiple ethnic groups:
Asian/Asian British:
Black/African/Caribbean/Black British:
Other ethnic group:
Do you consider yourself to have a disabililty or health condition

The information in this form is for monitoring purposes only. If you believe you need a ‘reasonable adjustment’, please discuss this with the manager running the recruitment process if you are a job applicant.

Sexual orientation?
What is your religion or belief?
What is your current working pattern?
What is your current flexible working arrangement?
Do you have caring responsibilities? (tick all that apply)

After you click 'SUBMIT' please wait for confirmation of sending before moving away from this form.

Thank you for your submission.

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