Equal Opportunities Monitoring Form

This form will be treated as strictly confidential and will be used for statistical monitoring only.

Tower Staff Construction Ltd is an equal opportunities employer. We have an equal opportunities policy, the aim of which
is to ensure that no job applicant receives less favourable treatment on irrelevant grounds (e.g. sex, race, colour, ethnic or
national origins, age, disability, religious, sexual orientation or marital status), nor is disadvantaged by conditions or
requirements which cannot be shown to be justified and relevant to the job.

In order to ensure that this policy is carried out, it is necessary for us to have some means of monitoring our recruitment
and selection activity. Only by such measures will we be able to identify potential sources of discrimination and take
remedial action. For this reason alone, we would be most grateful if you would answer the questions on the monitoring
form on the next page.

To carry out this approach we need your assistance and would be grateful if you would provide the information
requested; none of this information will be seen or used during the selection process.

What is your ethnic group?

Please select your age band A. Asian or Asian British
Bangladeshi
16 - 21 31-40 X 51 - 59 Over 65 Indian
Pakistani
22 - 30 41- 50 60 - 65 Prefer not to say Prefer not to say
Do you consider yourself to have a disability or health
condition? Any other Asian background, please write below:

Yes No X
Prefer not to say
B. Black or Black British
What is the effect or impact of your disability or health condition African
on your ability to give of your best at work? Caribbean
Prefer not to say

Please describe your gender Any other Black background, please write below:

Male X Female
Other Prefer not to say
C. Chinese
Do you identify as transgender (an individual who wants to change Chinese
their gender to the opposite of that they were assigned at birth)? Prefer not to say
Yes No X Prefer not to say Any other Chinese background, please write below:

What is your religion or belief?

Buddhist Muslim D. Mixed Heritage

Christian X No religion or belief White and Asian

White and Black African
Hindu Sikh White and Black Caribbean
Prefer not to say
Jewish Prefer not to say
Any other Mixed background, please write below:
Other religion or belief, please write below:

What is your sexual orientation? E. White

British
Bisexual (attracted to people of Lesbian (woman English
the same and attracted to other Irish
the opposite sex) women) Scottish
Welsh
Gay (man attracted to other Prefer not to say
men) Prefer not to say
Any other White background, please write below:
Heterosexual (attracted to
X WHITE ROMANIAN
people of the opposite sex)
F. I do not wish to disclose my ethnic group
Other, please write below:
Version 1 Issued 22/06/2018