Diversity Questionnaire

In accordance with our Company Equal Opportunities policy, we will provide equal opportunities to any
employee or job applicant and will not discriminate either directly or indirectly because of race, sex,
sexual orientation, transgender status, religion or belief, marital or civil partnership status, age, disability,
or pregnancy and maternity. We ask for information on your ‘protected characteristics’ in order to help
us monitor our performance on equality.

You are requested to complete this form and return it with your application paperwork. The information
you provide will be detached from your application form and will be kept separately from the information
to be used in the selection process.

Site/Branch
Position Applied for: Industrial
Date of Application Commercial
1. Gender Assigned at birth
✔ Male
 Female
 Prefer not to say
2. Which of the following best reflects how you would describe your gender identity?
✔ Male
 Female
 Prefer not to say
 In another way; please specify:
3. Does your gender identity align with the gender assigned to you at birth?
✔ Yes
 No
 Prefer not to say
4. Age
38
5. Marital status
 Married
 Civil partnership

✔ Single
 Prefer not to say
 Other: please specify:
6. What is your sexual orientation?
 Bi/Bisexual
 Gay/Lesbian

✔ Heterosexual/straight
 Prefer not to say
 Other term; please specify:
7. Do you consider yourself to have a disability under the Equality Act 2010?
In the Act, a person has a disability if:
 they have a physical or mental impairment
 the impairment has a substantial and long-term adverse effect on their ability to perform
normal day-to-day activities

This information is used only for monitoring purposes. If you believe you may be disabled and may
need any reasonable adjustments to be made as part of your employment, please discuss this with
your manager
 Yes

✔ No
 Prefer not to say

Page 1 of 2 GIGWD65 JUN 2021

 8. Religion or belief
 No religion or belief
 Buddhist
 Sikh

✔ Christian
 Jewish
 Hindu
 Muslim
 Other; please specify:
9. Ethnic Origin
(relates to a sense of identity/belonging on the basis of race/culture, not place of birth or
citizenship)

I would describe myself as (choose ONE section from A to E, and then tick the appropriate
box to indicate your cultural background):
A. White:
 British
 Irish
 Gypsy or Traveller

✔ Other White background, please specify: Eastern European
B. Mixed/Multiple ethnic groups:
 White and Black Caribbean
 White and Black African
 White and Asian
 Other Mixed/Multiple ethnic background, please specify
C. Asian, Asian British:
 Indian
 Pakistani
 Chinese
 Bangladeshi
 Other Asian background, please specify:
D. Black, African, Caribbean, Black British:
 African
 Caribbean
 Other Black, African, Caribbean background, please specify:
E. Other Ethnic Group:
 Arab
 Prefer not to say
 Other ethnic group background, please specify:

Gi Group will collect and process personal data relating to its candidates in line with the Data
Protection Act of 2018 and General Data Protection Regulation (Regulation (EU) 2016/679). The
organisation is committed to being transparent about how it collects and uses that data and
how it meets its data protection obligations. Details of how personal data is collected and
managed is contained within the Gi Group UK’s Privacy Notice which can be found at
www.gigroupuk.com/privacy. You may also be provided with a copy of the Privacy Notice during
the interview process. I hereby give my consent to Gi Group processing the data supplied in
this questionnaire for the purpose of monitoring the diversity of its workforce.

Thank you for assisting us by completing the Questionnaire

Page 2 of 2 GIGWD65 JUN 2021