Job Application Form Sheet

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Together project / service / department: What gender are you  Male  Do not wish to answer  Female Is your gender identity the same as the gender you were assigned at birth  Yes  Do not wish to answer  No What year were you born (leave blank if you do not wish to answer) What is your sexual orientation  Bisexual  Lesbian / gay woman  Gay man  Do not wish to answer  Heterosexual / straight  Other, write in How would you describe your faith / belief / religion  No Religion  Christian (including CofE, Catholic, Protestant and all other Christian denominations)  Buddhist  Hindu      Jewish Muslim Sikh Do not wish to answer Other, write in How do you describe your ethnic origin Choose one section from A to F, then tick one box to best describe your ethnic group or background A White  English / Welsh / Scottish / Northern Irish / British  Irish  Gypsy or Irish Traveller  Any other white background, write in C      E Asian / Asian British Indian Pakistani Bangladeshi Chinese Any other Asian background, write in Other ethnic group  Arab  Any other ethnic group, write in B     Mixed / multiple ethnic groups White and Black Caribbean White and Black African White and Asian Any other Mixed / multiple ethnic background, write in D Black / African / Caribbean / Black British  African  Caribbean  Any other Black / African / Caribbean background, write in F Undisclosed  Do not wish to answer The Disability Discrimination Act 1995 (DDA) defines a disabled person as someone with ‘a physical or mental impairment which has a substantial and long-term adverse effect on his ability to carry out normal day-to-day activities’..

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