New Role Application Form Survey

1.Please state the role title you are applying for

2.Sex(Required.)

Male

Female

I identify in another way

Prefer not to say

5.Gender reassignment (Required.)

Yes

No

Prefer not to say

Disability

Equality Act 2010 definition of disability

Under the Equality Act 2010, a person is considered to have a disability 'if they have a physical or mental impairment, and the impairment has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities’. ‘Substantial' is defined by the Act as 'more than minor or trivial'. An impairment is considered to have a long-term effect if:

·        it has lasted for at least 12 months

·        it is likely to last for at least 12 months, or

·        it is likely to last for the rest of the person’s life.

6.Do you have a disability?(Required.)

Yes

No

Prefer not to say

Ethnic Group, if you would prefer not to say please skip to question 12.

9.Mixed/multiple ethnic groups

White and Black Caribbean

White and Black African

White and Asian

Other (please specify)

11.Black/African/Caribbean/Black British

African

Caribbean

Other (please specify)

12.Other

Arab

Other (please specify)

14.Marriage/Civil Partnership(Required.)

Married

Civil Partnership

Neither

Prefer not to say

15.Pregnancy/Maternity(Required.)

Yes

No

Prefer not to say