Every year, the University must provide the Higher Education Statistics Agency (HESA) with information about its employees. Please be assured that this information is completely anonymous and you cannot be identified from it. It is essential that the information we provide is accurate as it is used externally to monitor funding, compile league table results and is included in published documents.
Please complete the details below and return to your Human Resources Team as soon as possible.
Section A: Personal Details
Full Name
Faculty/Department
Date of Birth
NI Number
Section B: Information Required by HESA
HESA Staff identifier (if known)
1. What is your legal sex?
(this is the sex that is recorded on your birth certificate) Male Female
2. Trans or transgender people are those who identify themselves as someone whose gender is different to that in which they were born. Some may have gone through medical treatment and others may have decided not to.
Do you identify yourself as trans/transgender? Yes No Prefer not to say
3.
Ethnic Origin - Please select the category that best reflects your ethnic origin (if no option below is ticked, the category ‘not known’ will be entered on your records) :
Asian or Asian British - Bangladeshi Black Other* Other Mixed Background*
Asian or Asian British – Indian Chinese Prefer not to say
Asian or Asian British - Pakistani White Any Other Ethnic Origin*
Asian Other* White & Asian * Please specify below
Black or Black British – African White & Black African
White & Black Caribbean Black or Black British – Caribbean
4. Nationality Please indicate your nationality below (if no details are provided, the category ‘not known’ will be entered on your records) :
Nationality:
5. Religion - Please select the category that best reflects your religion:
Buddhist
Christian
Hindu
Jewish
Muslim
Sikh
Spiritual
Any other religion or belief
6. Sexual Orientation Please select the category that reflects your sexual orientation:
Bisexual Gay woman/lesbian
Gay man Heterosexual
No religion
Prefer not to say
Other
Prefer not to say
Document created: Aug 14

7. Disability - The Disability Discrimination Act (DDA) defines a disability as “physical or mental impairment, which has a substantial and longterm adverse affect on a person’s ability to carry out normal day to day activities.” The
University is committed to providing a work environment which is open to all and to respond, as appropriate to the needs of people with disabilities.
Do you consider yourself to have a disability?
(please tick)
Yes No Prefer not to say
If yes, you are invited to give details of the nature of your disability by putting an X in the appropriate box(es) below:
I have two or more impairments and/or disabling medical conditions
I have a specific learning disability (such as dyslexia or dyspraxia)
I have a general learning disability (such as Down’s Syndrome)
I have a social/communication impairment (such as Asperger’s syndrome or other autistic spectrum disorder)
I have a long-standing illness or health condition (such as cancer, HIV, diabetes, chronic heart disease or epilepsy)
I have a mental health condition (such as depression or schizophrenia)
I have a physical impairment or mobility issues (such as difficulty using arms or using wheelchair or crutches)
I am deaf or have a serious hearing impairment
I am blind or have a serious visual impairment
I have a disability not listed above (please specify)
8. Previous Employment Please indicate your last employment prior to joining this institution:
Another Higher Education Institution in UK
(please state which university in the space below)
Other public sector in UK
Private industry/commerce in UK
Higher Education Institution overseas
Other education institution in UK
Self-employed in UK
Other employment in UK
Other education institution overseas
Research Institution in UK
Research Institution overseas
Student in UK
Other employment overseas
Private research institute in UK
Private research institute overseas
Public research institute in UK
Student Overseas
NHS/General medical or General dental practice in UK
Public research institute overseas
Working in the voluntary sector
Health service overseas Not in regular employment
9. Highest Academic Qualification – Please indicate your highest academic qualification from the options below:
Doctorate Diploma of HE
HND/HNC
Other Undergraduate qualification (including professional)
Other Higher Degree
PGCE
Other Postgraduate qualification (including professional)
First Degree
First Degree with Qualified Teacher Status
Other qualifications at first-degree level
(including professional)
Document created: Aug 14
‘A’ Level, Scottish Higher or equivalent (NVQ,SVQ level3)
‘O’ Level/GCSE or equivalent (NVQ/SVQ level 2)
Other qualification
No qualifications

10. Current Academic Subject - Please enter below the subject(s) that you teach/research in your current position at DMU:
Academic subject(s):
11. Academic Teaching Qualification - Please indicate if you hold any of the teaching qualifications listed below:
Successfully completed an institutional provision in teaching in the higher education sector accredited against the
UK Professional Standards Framework
Recognised by the Higher
Education Academy (HEA) as:
Associate
Fellow
Fellow
Senior
Fellow
Principal
Fellow
A National Teaching Fellowship scheme Individual Award
A PGCE in higher education, secondary education, further education, life long learning or any other equivalent UK qualification
Accredited as a teacher of their subject by a professional UK body
Other UK accreditation or qualification in teaching in the higher education sector
Overseas accreditation or qualification in teaching in the higher education sector
No qualification held
12.
Regulatory Body - If you are currently registered to practice in a Medical, Health or Social Care Profession please indicate below which:
General Medical Council (GMC) Scottish Social Services Council (SSSC)
General Dental Council (GDC)
General Optical Council (GOC)
Care Council for Wales (CCW)
N. Ireland Social Care Council (NISCC)
The Pharmaceutical Society of Northern Ireland (PSNI)
Signature
The Nursing & Midwifery Council (NMC)
Health & Care Professions Council (HCPC): excluding social workers in England
Health & Care Professions Council (HCPC): social workers in England
General Osteopathic Council (GOsC)
General Chiropractic Council (GCC)
Royal College of Veterinary Surgeons
(RCVS)
General Pharmaceutical Council (GPhC)
Date
Thank you for completing this information. Please now return it to the Human Resources Team, Eric Wood Building, The
Gateway, Leicester. If you would prefer to email it, please send to kyork@dmu.ac.uk
Document created: Aug 14