SAMPLE ETHNIC ORIGIN AND GENDER MONITORING QUESTIONNAIRE - DOC

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SAMPLE ETHNIC ORIGIN AND GENDER MONITORING QUESTIONNAIRE - DOC Powered By Docstoc
					                                                                                                       9 Gough Square
                       ETHNICITY & DIVERSITY MONITORING
In line with our Chambers’ equal opportunities policy and advice in the Equality Code for the Bar, we collect ethnic
origin and gender information from all applicants to Chambers so that we can assess the effectiveness of our
policies. The information we collect will be treated as confidential information.

This information will be used to compile statistical analyses and reports and will not be released to anyone in a way
which might identify any individual. The data collected will not be used in any selection process and is kept only
for monitoring purposes. For online applicants please insert a tick as appropriate by placing the cursor immediately
in front of the check box, double left click with your mouse and select the tick symbol from the wingdings window.

NAME

DATE


POSITION APPLIED FOR

9GS                 CURRENT TENANT                                  STAFF MEMBER                           

APPLICANT           FIRST TENANCY                                   ESTABLISHED TENANT                     

PUPIL               FIRST 12 MONTH                                  THIRD SIX                              


AGE                                   DATE of BIRTH                                MALE                FEMALE 


DO YOU CONSIDER YOURSELF DISABLED?                                       Y                      N      

ARE YOU REGISTERED DISABLED?                                             Y                      N      


WHAT IS YOUR ETHNIC GROUP?
Choose one section from (a) to (e) and tick the appropriate box to indicate your cultural background

(a)      WHITE                                             (b)      BLACK or BLACK BRITISH
              British                                                   Caribbean
              Irish                                                     African
              Any other White background                                Any other Black background
               please write in below                                      please write in below
                  ………………………………                                               …………………………….

(c)      ASIAN or ASIAN BRITISH                            (d)      MIXED
               Indian                                                      White and Black Caribbean
               Pakistani                                                   White and Black African
               Bangladeshi                                                 White and Asian
               Any other Asian background                                  Any other Mixed background
                please write in below                                        please write in below
                  ……………………………..                                              ………………………………

(e)      CHINESE or OTHER ETHNIC GROUP
                 Chinese
                 Any other Mixed background
                  please write in opposite



The ethnic origin categories are those used in the 2001 Census (Office of Population Censuses and Surveys) and are
recommended by the Commission for Racial Equality and the Bar Council.