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CONFIDENTIAL

Sexual Orientation:

Please indicate your sexual orientation:

Heterosexual

Transsexual

Bisexual

Gay

Lesbian

Other

I do not wish to disclose my sexual orientation to Hampshire County Council

Disability

Disability is described by the Equality Act 2010 as a physical or mental impairment that has a substantial long term adverse effect on an individual's ability to carry out normal day to day activities.

Applications from disabled people are welcome.  We will ensure that appropriate support is provided where required, both in the recruitment and selection process, and during employment.

Do you consider yourself to have a disability?

Yes

No

I do not wish to disclose my disability data to

Hampshire County Council

Thank you for completing this form.

Please return in a sealed envelope with your application form

stating your name, post applying for and the School/ Children’s Centre.

The above information will not be shared with the selection panel prior to interview.

This information will be retained, confidentially, and used for payroll/ monitoring purposes.

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