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$7g$7g = ? n n 8 . D r L3 b - - - 2 2 2 2 2 2 2 $ 4 7 2 . - - ^ . . 2 n n b , 3 g1 g1 g1 . | n n R L 2 g1 . 2 g1 g1 " g1 e / R g1 2 3 0 L3 g1 r8 a/ r8 g1 r8 g1 P - " . g1 &. :. Y - - - 2 2 C0 $ - - - L3 . . . . r8 - - - - - - - - - X 4 : United Learning Applicant Monitoring Form
Position Applied for: ____________________________________________________
Please complete the following section for reporting purposes only. United Learning is committed to a policy of equality 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.
Forename(s): Surname: Previous Name(s):Title: Dr/Mr/Mrs/Miss/Ms/Other (Please state)Gender: Male/Female/Other gender identity Age: 16-19/20-29/30-39/40-49/50-50/60-64/65+/Prefer not to say
Ethnic Origin
Please tick a box from the list below which best describes the ethnic group to which you belong.
WhiteBritish (A1)Irish (A2)Other White background (A3). Please specifyMixed RaceWhite and Black Caribbean (B1)White and Black African (B2)White and Asian (B3)Other Mixed background (B4). Please specifyAsian or Asian BritishIndian (C1)Pakistani (C2)Bangladeshi (C3)Other Asian background (C4). Please specifyBlack or Black BritishCaribbean (D1)African (D2)Other Black background (D3). Please specifyChinese or Other Chinese (E1)Ethnic GroupOther Chinese background (E2). Please specifyPrefer not to say
Vacancy Monitoring: Where or how did you hear about the position? If in a publication, which one(s) did you see?
HR July 2011
Strictly Confidential
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