Equal Opportunities Monitoring Thank you for submitting your application. We would be grateful if you could spend a couple of minutes to complete this equal opportunities monitoring form. —————————– National Energy Action (NEA) is a national charity which is committed to providing equal opportunities for its staff and job applicants. NEA’s Equality and Diversity Policy is regularly reviewed to ensure it achieves the its objectives of ensuring that no applicant or member of staff receives less favourable treatment on grounds of religion or belief, race, colour, nationality, ethnic or national origins, age, disability or health condition, gender/sex, marital status, sexual orientation or political affiliation. As part of this review, NEA monitors job applications for the ethnic origin, age, sex/gender and the disability/health status of the applicants. As part of this process, you are requested to complete this questionnaire, which is totally anonymous, and will be forwarded to NEA’s HR department separate from your application. You will not be asked to provide any identifying information. NEA needs your help and co-operation to enable it to do this, but filling in this form is voluntary. All replies will be treated in the strictest confidence and the information will only be used internally by NEA as part of the monitoring of its equal opportunities policy. No information will be provided to any other individual or organisation. Thank you for your co-operation. Which job have you applied for?(Required) Please select the nation that the job you have applied for is based in(Required) England / Wales / Scotland Northern Ireland CommunityPlease indicate the community to which you belong by ticking the appropriate box below: I am a member of the Protestant Community I am a member of the Roman Catholic Community I am not a member of either the Protestant or the Roman Catholic communities Cultural/ethnic originWhite English/Welsh/Scottish/Northern Irish/British Irish Gypsy/Irish Traveller Other Mixed / multiple ethnic groups White and Black Caribbean White and Asian White and Black African Other Asian / Asian British Indian Pakistani Bangladeshi Chinese Other Black / African / Caribbean / Black British African Caribbean Other Other ethnic group Arab Other Age RangeAge range 16-18 years 19-25 years 26-35 years 36-45 years 46-55 years 56-65 years 66-75 years Over 75 years GenderWhat is your gender? Male Female Other Prefer not to say DisabilityDo you consider yourself to have a disability or health condition? Yes No Prefer not to say What is the effect or impact of your disability or health condition on your ability to give your best at work?The information in this form is for monitoring purposes only. If you believe you need a ‘reasonable adjustment’, then please contact us to give us details of what this needs to be so that we can set it up in advance of any interview.Please state where you saw this job advertised