Crystal Palace Community Trust
Equal Opportunities Monitoring Form

In line with our Equal Opportunities Policy, we operate a monitoring procedure to record the sex, age and racial origin of all our applicants. This aids the regular checking of our recruitment and selection process which we carry out to ensure that no group is put at a disadvantage either directly or indirectly.

1 Job applied for:

2

Date of Birth

Sex

3 How would you describe your racial origin/ethnic group? Please tick one box

White

o

Asian

British

o

British

o

Irish

o

Indian

o

Portuguese

o

Pakistani

o

Any other white background

o

Bangladeshi

o

Any other Asian background

o

Black

Other Ethnic Groups

British

o

Chinese

o

Caribbean

o

Vietnamese

o

African

o

Other ethnic group not stated

o

Any other Black background

o

Mixed

White & Black British

o

White & Black African

o

White & Asian

o

4 NATIONALITY: _____________________________________________________

5 Disability:- Do you consider yourself disabled? YES/NO

If YES, are you registered disabled? YES/NO

If YES, please give number: ______________________________________________

6 *Offending:- Have you ever been convicted of a criminal offence(s): NO

If YES, please give details: ______________________________________________

______________________________________________________________________

(Do not include parking, speeding offences or other minor traffic offences)