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Equal Opportunities Monitoring Form

Please write clearly in black ink, or type in the form. Please answer all the questions.
POSITION APPLIED FOR: HOPE worldwide UK Housing and Support Worker
The sole purpose of this form is to monitor the effectiveness of our recruitment, particularly in terms of
our equality of opportunity. The information on this form will not be used at any stage of the selection
process: it is separated from your completed application form upon receipt.
1. Where did you hear about this vacancy?
.
2. Please tick boxes below to describe your ethnic/national origin. Please answer both Part A & Part B, if
possible. For example, if you consider yourself to be Black British, indicate Black in Part A & British in
Part B.

Part A

Part B

Asian
Black
Mixed Race
White
Other (please specify)

African
African Caribbean
British
Chinese/Vietnamese
Sri Lankan
Indian/Bangladeshi
Pakistani
Irish
Jewish
Other (please specify)

3. Please tick the box below to describe your sexual orientation:


Heterosexual

Homosexual

4. Please indicate your Gender:

Bisexual
M

Other
Other

(please specify)
(please specify)

5. Please tick the box that best describes your religion:


Christian
Buddhist

Muslim
Atheist

Jewish
Agnostic

Sikh
Other

6.1 Do you consider yourself to be disabled?


6.2 Are you registered disabled?

Hindu
(please specify)
YES/NO
YES/NO

7. Please state any spoken or written language skills you may have, in languages other than English.
.