Please complete this section from information on the job advert.
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Recruitment monitoring form This section forms an integral part of the application form and must be completed in full and accurately. This form is confidential and will not be seen by the selection panel. The information provided on this document will be used by the Trust only to monitor the effectiveness of its equal opportunities and recruitment policies, and will be used only as part of aggregated statistics. Please complete the following boxes as appropriate (use black pen if completing the form by hand).
Sex Female Male Other/prefer not to say	Disability Do you consider yourself to be a disabled person? Yes No
What is your ethnicity? Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong. Please tick the appropriate box White English Welsh Scottish Northern Irish Irish British Gypsy or Irish Traveller Prefer not to say Any other white background, please write in: Mixed/multiple ethnic groups White and Black Caribbean White and Black African White and Asian Prefer not to say Any other mixed background, please write in: Asian/Asian British Indian Pakistani Bangladeshi Chinese Prefer not to say Any other Asian background, please write in: Black/ African/ Caribbean/ Black British African Caribbean Prefer not to say Any other Black/African/Caribbean background, please write in: Other ethnic group Arab Prefer not to say Any other ethnic group, please write in:	Age Please indicate the band in which your age falls. Under 25 25 - 34 35 - 49 50 - 65 Over 65 Postcode: Vacancy (mark only one) I became aware of this vacancy through: Birmingham Evening Mail Community Care Express & Star Job Centre Job Bulletin Other specialist publication* Recruitment fair The Guardian Times Educational Supplement Website (council) Website (other)* * Please specify publication / website: