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  • Equal Opportunities Monitoring Form Gender Identity:: Page 1 of 2

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    Jerome Dulin
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    This document is an equal opportunities monitoring form collecting information about gender identity, sexual orientation, ethnic origin, disability status, and disability type from an applicant or employee. The form includes options for female, male, non-binary or prefer not to say for gender identity and bisexual, gay, lesbian, straight or prefer not to say for sexual orientation. It also lists ethnic origin categories and asks if the respondent identifies as disabled, and if so to describe the disability.

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    Equal-Opportunities-Monitoring-Form

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    This document is an equal opportunities monitoring form collecting information about gender identity, sexual orientation, ethnic origin, disability status, and disability type from an applicant or employee. The form includes options for female, male, non-binary or prefer not to say for gender identity and bisexual, gay, lesbian, straight or prefer not to say for sexual orientation. It also lists ethnic origin categories and asks if the respondent identifies as disabled, and if so to describe the disability.

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    8 views2 pages

    Equal Opportunities Monitoring Form Gender Identity:: Page 1 of 2

    Uploaded by

    Jerome Dulin
    This document is an equal opportunities monitoring form collecting information about gender identity, sexual orientation, ethnic origin, disability status, and disability type from an applicant or employee. The form includes options for female, male, non-binary or prefer not to say for gender identity and bisexual, gay, lesbian, straight or prefer not to say for sexual orientation. It also lists ethnic origin categories and asks if the respondent identifies as disabled, and if so to describe the disability.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    One World Media

    CAN Mezzanine
    32-36 Loman Street
    London SE1 0EH

    +44 (0) 20 7922 7941

    www.oneworldmedia.org.uk

    Equal Opportunities Monitoring Form

    Gender Identity:
    Female
    Male
    Non-binary
    Prefer not to say

    Sexual Orientation:
    Bisexual
    Gay Man
    Gay Woman/Lesbian
    Heterosexual/Straight
    Prefer not to say

    I would describe my ethnic origin as:

    A: White D: Black or Black British


    British African
    Irish Caribbean
    Gypsy or Traveller Any other Black/African/Caribbean
    Any other White Background
    E: Other
    B: Mixed Arab
    White and Black Caribbean Any other ethnic Group
    White and Black African Prefer not to say
    White and Asian
    Any other Mixed/Multiple Ethnic

    C: Asian or Asian British


    Indian
    Pakistani
    Bangladeshi
    Chinese

    Page 1 of 2
    One World Media
    CAN Mezzanine
    32-36 Loman Street
    London SE1 0EH

    +44 (0) 20 7922 7941

    www.oneworldmedia.org.uk

    Do you identify as disabled?


    Yes
    No
    Prefer Not to Say

    If you identify as disabled, how would you describe your disability?


    Visual Impairment
    Hearing Impairment/Deaf
    Physical Disabilities
    Physical Disabilities
    Cognitive or learning Disabilities
    Mental Health condition
    Other Long term/Chronic Conditions

    Page 2 of 2

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