equalitiesmonitoringquestionnaire by 88Xh49


									             Glasgow City
             CouncilEqualities Monitoring Questionnaire
                                                                                                                             APP 2
Glasgow City Council is an Equal Opportunities Employer and all applicants for jobs will receive equal treatment irrespective
of their age, disability, gender re-assignment, marriage or civil partnership, pregnancy and maternity, race, religion or belief,
sex or sexual orientation.

In order to help the Council to ensure that its equal opportunity policy is being carried out, would you please provide the
information requested below. This information will be kept in strictest confidence separate from your application form and
used for statistical purposes only. Please note, the provision of information in this section is entirely voluntary and, if you
chose not to do so, this will not be held against you when considering your suitability for the job. Thank you for your co-
       Service:                                                Advert Reference No.

       Job Title:                                              Location/Section:

       Age Group – please tick to indicate which age group you fall within:

       Under 25            25-30            31-40           41-50                  51-60           61- 64     65+
       Please tick the appropriate box to indicate your sex

       Sex                               Female                               Male                   Non Disclosed

       Are you currently in paid employment?                                  Yes                    No

       Where did you see this post advertised?

       Please show your ethnic origin by ticking one of the boxes below.

                  Scottish                     Other British                               Irish

                  Gypsy/Traveller              Polish                                  Other White ethnic

                  Mixed or multiple ethnic group


                  Pakistani, Pakistani Scottish or Pakistani British

                  Indian, Indian Scottish or Indian British

                  Bangladeshi, Bangladeshi Scottish or Bangladeshi British

                  Chinese, Chinese Scottish or Chinese British

                  Other Asian background

                  African, African Scottish or African British

                 Other African background

                 Caribbean or Black

                 Caribbean, Caribbean Scottish or Caribbean British

                 Black, Black Scottish or Black British

                 Other Caribbean or Black background

                 Other ethnic

                 Arab, Arab Scottish or Arab British

                  Other ethnic background

                 Non disclosed

         Please show your religion and belief by ticking one of the boxes below.

                  Buddhist                     Church of Scotland                  Hindu

                 Jewish                        Muslim                              Other Christian

                 Roman Catholic                 Sikh                               Another Religion

                  None                          Non Disclosed

         Please show your sexual orientation including gender identity by ticking one of the boxes below.

                  Bi-sexual                    Heterosexual                          Lesbian/Gay

                 Transgender                   Other                               Non Disclosed

         Are you an employee of Glasgow City Council?            Yes                             No

         Do you consider yourself to have a disability?          Yes                  No               Non Disclosed
         Please show your disability by ticking one of the boxes below.

                  Deafness or partial hearing loss                        Blindness or partial sight loss

                 Physical disability                                      Learning disability

                 Learning difficulty                                      Mental health condition

                 Long term illness                                        Development disorder

                  Other condition                                         Non disclosed

Version 5.0                                                                                                            February 2011

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