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Equal opportunities monitoring form

West Berkshire Council

Please complete and email with your application to Recruitment@westberks.gov.uk. Please quote the post ref.no and closing date. If completing this form online, please click over the grey areas to overwrite them.

POST REF:

CLOSING DATE:

Amey West Berkshire supports the principle of equal opportunities in employment and opposes all forms of unlawful and unfair discrimination. In pursuit of this policy Amey West Berkshire will use its best endeavours to ensure that the human resources, talents and skills available throughout the community are considered when employment opportunities arise in order to achieve and maintain an efficient workforce. Amey West Berkshire aims to ensure that job applicants and employees are treated equally and fairly and are recruited, selected, trained and promoted on the basis of job requirements, skills, abilities and other objective and job related criteria. We will also ensure that individuals are not disadvantaged by conditions or requirements, which cannot be shown to be justified as being necessary for the safe and effective performance of the job.

To ensure that Amey West Berkshire’s equal opportunities policy is being implemented and to comply with legislation, please complete and return this form. This information will be used solely for monitoring purposes and will not be available to those involved in the selection process.

Last Name:

Post Title as advertised:

First Names:

Location/Work base:

Date of Birth:

Age:

Where did you see this

Sex Discrimination Act 1975

Please mark the appropriate boxes with an x by clicking once

Female

Male

Single

Married

Widowed

Divorced

Race Relations Act 1976

How would you describe your ethnic origin?

Asian or Asian Black

Black or Black British

Other Ethnic Groups

Indian

Caribbean

Chinese

Pakistani

African

Any other

Bangladeshi

Any other black

ethnic group

background

Disability Discrimination Act 1995

West Berkshire Council seeks to ensure that it does not unjustifiably discriminate against people with disabilities in employment. To assist us in fulfilling our obligations under the Disability Discrimination Act 1995 please provide details of any health problem or disability that is relevant to your job application; and how, if at all, it affects your performance at work, This will enable us to determine what reasonable adjustments may be required in the workplace.

White British

Irish

Any other White background

Mixed White & Black

Caribbean

White & Black African White & Asian

Any other mixed background

Signed:

Date:

Any information held on this form will be subject to the Data Protection Act 1984 and 1998. By emailing this document to us, you give your agreement with the declarations stated above. Applicants may be required to sign their form at a later date.

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