Strictly Confidential
Equal Opportunities Monitoring Form
Section 1- this section is compulsory
Please complete the following section. The information will not be used as part of the selection process
and will not be disclosed to the selection panel.
Forename(s):
Surname:
Previous Name(s):
Title:
Gender:
Dr / Mr / Mrs / Miss / Ms / Other
Place of Birth:
M/F
Date of Birth:
National Insurance Number:
Section 2 - this section is voluntary
SSFC is committed to a policy of equal opportunities in employment. To help us monitor the
effectiveness of this policy it would be helpful if you would complete the following sections. The
information will not be used as part of the selection process and will not be disclosed to the selection
panel.
Please tick a box from the list below which best describes the ethnic group to which you belong.
White
Mixed Race
Asian or Asian British
Black or Black British
Chinese or Other
Ethnic Group
British
Other White background
White and Black Caribbean
White and Asian
Other Mixed background
Indian
Bangladeshi
Other Asian background
Caribbean
Other Black background
Chinese
Other
Irish
Please specify
White and Black African
Please specify
Pakistani
Please specify
African
Please specify
Please specify
Do you have any permanent or recurrent illnesses or
disabilities? If yes, please specify. (SSFC has been
awarded the disability symbol employer status. We
guarantee to interview all disabled applicants who meet
the minimum criteria for the post.)
Would you require any special arrangements/facilities if
you were invited for interview/testing? If yes, please
specify.
For Internal Use Only
Date received:
Ref No:
Shrewsbury Sixth Form College, Priory Road, Shrewsbury, SY1 1RX
SSFC is committed to equal opportunities and welcomes applications
from all sections of the community