Equal opportunities Monitoring Form
Techniquest is committed to opportunity and welcomes applicants from all sections of the community.
To help us monitor Techniquest’s recruitment, please complete the following information, which will be
detached from your application before the short-listing process, and kept anonymous.
Your co-operation in completing this form would be appreciated.
Age
Please tick which age group you fall into:
18-24
25-34
35-44
Gender
Please tick one:
Male
Marital Status
Are you:
Single
Female
Married
45-54
Transsexual
Civil
Partner
55-64
65-75
Transgender
Divorced
Ethnicity
How would you describe your Ethnic Group? Please tick one:
White
British
Irish
Other
White
Black or Black British
Caribbean
African
Other Black
Mixed
White/Black
Caribbean
Asian
Indian
Other Ethnic Group
Chinese
White/Black
African
White/Asian
Other
Mixed
Pakistani
Bangladeshi
Other
Asian
Other
Group
Disability
Do you suffer from a recognised disability as outlined in the Equality Act 2010? (Disability
Definition: a physical or mental impairment which has a substantial and long-term
adverse effect on ones ability to carry out normal day-to-day activities’)
If YES, please state nature of
disability.
How did you hear about this job vacancy?
Newspaper
Techniquest
Website
Agency
Other
(please
state)
Yes/No