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ETHNIC MONITORING and ASSISTANCE QUESTIONNAIRE
FOR POSITIONS ON FOOD STANDARDS AGENCY ADVISORY
COMMITTEES
Position applied for:
Chair
Member
Both
MEMBERSHIP OF COMMITTEE ON ADVISORY COMMITTEE ON NOVEL FOODS AND
PROCESSES
The Government has a policy of equality of opportunity for those wishing to serve in public
appointments. That means that applications are welcome from all suitable individuals
irrespective of, for example, race, gender or disability. In order to ensure that this policy is
being complied with, applicants are asked to complete the questions below. This
information will be used for statistical purposes only and it will be presented in the form of
totals from which individuals cannot be separately identified.
Date of Birth
Gender:
Age
Male
Female
Disability:
Do you consider yourself disabled?
Yes
If so, please complete the assistance questionnaire
Advertising
How did you hear of this vacancy?
FSA website
FSA News
The Guardian
Other
Nature:
Please give description:
1
British Medical Journal
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ASSISTANCE FOR INTERVIEW AND PERFORMANCE IN POST
To ensure we do not create any barriers in our selection process and to help us implement
our equal opportunities policy effectively. Please let us know if you would like us to provide
any particular assistance for your interview and, if appointed your performance in post, by
answering the questions below.
Please tick below to show what assistance you would like for your interview:
Induction loop
Sign language interpreter (type:
)
Keyboard for written tests (if applicable)
Someone with you at the interview (eg speech facilitator)
Car parking
Assistance in and out of a vehicle
Wheelchair access
Other assistance (please specify)
Please describe any special arrangements that would help you carry out public appointment
duties
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Which groups do you most identify with? Please tick only ONE box in column A and ONE
box in column B (The options are listed alphabetically).
Column A
Column B
ASIAN
(A)
(B)
(C)
(D)
(E)
(F)
British or Mixed British
English
Irish
Scottish
Welsh
Or any other? (specify if you wish)
(A)
Bangladeshi
Indian
Pakistani
Any other Asian background (specify if you wish)
(B)
(C)
(D)
BLACK
(E)
African
Caribbean
Any other Black background (specify if you wish)
(F)
(G)
CHINESE
(H)
Any Chinese background (specify if you wish)
MIXED ETHNIC BACKGROUND
(I)
Asian and White
Black African and White
Black Caribbean and White
Any other Mixed ethnic background
(specify if you wish)
(J)
(K)
(L)
WHITE
(M)
Any White background (specify if you wish)
ANY OTHER ETHNIC BACKGROUND
Any other ethnic background (specify if you wish)
(N)
3