Inclusive Boards | Diversity Monitoring Form

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Introduction

Our client(s) wants to meet the aims and commitments set out in their equality and diversity policy. This includes not discriminating under the single Equality Act 2010, and building an accurate picture of the make-up of the workforce and board members in encouraging equality and diversity. The organisation needs your help and co-operation to enable it to do this, but filling in this form is voluntary.

This form will ask information about your gender identity, your ethnicity, background, disability status, special category information and other relevant information we feel will support in building as full a picture as possible. You have every right to skip a question, but where possible, please answer all questions. If you have a particular reason for not wanting to answer a question, leave that question blank.

The information you provide will stay confidential, and will be reviewed and processed separately from the application(s) you make.

If you would like a copy of this form in another format please contact: hello@inclusiveboards.co.uk

Thank you for completing this form.

Title

Full Name

Please detail the position you are applying for

Please state the name of the organisation you are applying to

Which age bracket do you fall into?

16-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65+

Prefer not to say

Clear selection

What is your gender?

Man

Woman

Non-binary

Prefer not to say

Other:

Clear selection

If you identify as transsexual, transgender (in that you have effected a permanent change of gender identity) or as intersex which group do you identify with?

Transsexual

Transgender

Intersex

Prefer not to say

Clear selection

Is your gender identity the same as the gender you were originally assigned at birth?

Yes

Prefer not to say

Clear selection

Are you married or in a civil partnership?

Yes

Prefer not to say

Clear selection

How would you describe your ethnic origin?

White - English/Welsh/Scottish/Northern Irish/Irish/British/Gypsy/Traveller

White - European

White - Other

Black - African/Caribbean/Black British

Black - European/Black American

Black - Other

Asian - British/Asian European

Asian - Other

Mixed/Multiple Ethnic Groups

Prefer not to say

Other:

Clear selection

Do you consider yourself to have a disability or health condition?

Yes

Prefer not to say

Other:

Clear selection

If 'Yes', please state below

What is your sexual orientation?

Heterosexual

Gay woman/lesbian

Gay man/homosexual

Bisexual

Prefer not to say

Asexual

Other:

Clear selection

What is your religion or belief?

No religion or belief

Buddhist

Christian

Hindu

Jewish

Muslim

Sikh

Prefer not to say

Other:

Clear selection

What is your current working arrangement?

None

Flexi-time

Staggered hours

Term-time hours

Annualised hours

Job-share

Flexible shifts

Compressed hours

Homeworking

Prefer not to say

Other:

Clear selection

Do you have caring responsibilities?

None

Primary carer of a child/children (under 18)

Primary carer of a disabled child/children

Primary carer of a disabled adult (18 and over)

Primary carer of older person

Secondary carer (another person carries out the main caring role)

Prefer not to say

Other:

Clear selection

What type of school did you mainly attend between the ages of 11 and 16?

State-run or state-funded school - selective on academic, faith or other grounds

State-run or state-funded school - non-selective

Independent or fee-paying school - bursary

Independent or fee-paying school - no bursary

Attended school outside the UK

Don’t know

Prefer not to say

Other:

Clear selection

What is the highest level of qualifications achieved by either of your parent(s) or guardian(s) by the time you were 18?

At least one has a degree level qualification

Qualifications below degree level

No formal qualifications

Don’t know

Not applicable

Prefer not to say

Other:

Clear selection

Thinking back to when you were aged about 14, which best describes the sort of work the main/ highest income earner in your household did in their main job?

Modern professional occupations such as: teacher/lecturer, nurse, physiotherapist, social worker, welfare officer, artist, musician, police officer (sergeant or above), software designer

Clerical and intermediate occupations such as: secretary, personal assistant, clerical worker, office clerk, call centre agent, nursing auxiliary, nursery nurse

Senior managers and administrators usually responsible for planning, organising and co-ordinating work and for finance such as: finance manager, chief executive

Technical and craft occupations such as: motor mechanic, fitter, inspector, plumber, printer, tool maker, electrician, gardener, train driver

Semi-routine manual and service occupations such as: postal worker, machine operative, security guard, caretaker, farm worker, catering assistant, receptionist, sales assistant

Routine manual and service occupations such as: HGV driver, van driver, cleaner, porter, packer, sewing machinist, messenger, labourer, waiter / waitress, bar staff

Middle or junior managers such as: office manager, retail manager, bank manager, restaurant manager, warehouse manager, publican

Traditional professional occupations such as: accountant, solicitor, medical practitioner, scientist, civil/mechanical engineer

Long term unemployed (claimed Jobseeker's Allowance or earlier unemployment benefit for more than a year)

Retired

Not applicable

Don’t know

Prefer not to say

Clear selection

Where did you hear about this opportunity?

Direct Engagement

Inclusive Boards Website

Job Platforms - Indeed, CV Library etc

Social Media

Word of Mouth

Other:

Clear selection

Data Protection and Privacy Notice

Confidentiality

Maintaining the confidentiality of your information is of utmost concern to us. The information collected as part of this form will be held in confidence and will only be used for the purpose set out in relation to executive search and advisory. For the purposes of the General Data Protection Regulation ("GDPR") and UK data protection laws, the data controller is INCLUSIVE BOARDS LIMITED. To find out more about how we store and process data, please visit http://www.inclusiveboards.co.uk/privacy-policy/

How will the information be used (data)?

Data management will follow General Data Protection Regulation ("GDPR") and UK data protection laws. We will not publish any information about you that could identify you to someone else publicly. Data provided to us will be used for the purposes set out at the time of collection and, where relevant, in accordance with any preferences you express.

Who will the data be shared with?

By answering the questions you are giving consent to having your data stored and processed by Inclusive Boards for the purposes of executive search and advisory. Inclusive Boards may distribute, share and publish anonymous information, statistics and data from in the form of reports, graphs, tables, text and other formats ONLY for the purposes of executive search and advisory. Inclusive Boards will not be sharing any data collected with any entity outside of the EEA.

Your rights under GDPR

You have the right to withdraw your answers to this form at anytime by contacting data@inclusiveboards.co.uk. You also have the right to request to review, modify or delete your responses at any time. You can find the full list here of your rights under GDPR here: https://ico.org.uk

I have read carefully the data protection and confidentiality information and by ticking the box below, I agree to give consent to Inclusive Boards to process data collected in this form including personal and special category data in accordance with the information provided. *

I give my full consent

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