Equality & Diversity Monitoring Form

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About this form

The University of Oxford, and within that Reuben College, is committed to fostering an inclusive culture which promotes equality, values diversity and maintains a working, learning and social environment in which the rights and dignity of all its members are respected.

We collect data on applicants to posts in order to monitor our progress in promoting equality and to inform any changes that may be needed to our policies, practices and services. This information does not form any part of your application, and will not be seen by any member of the Selection Committee. Collated data will be reviewed once selection decisions have been made to analyse the demographics of the applicant pool.

All personal information will be treated in accordance with the Data Protection Act (1998), and data used for statistical monitoring will be anonymised and published in a way that does not allow individuals to be identified.

For more information on equality and diversity at Oxford, including staff networks, training and support available for staff with disabilities, please see: www.admin.ox.ac.uk/eop.

You can complete this form online, or download a Word version to complete and email to: human.resources@reuben.ox.ac.uk

Title of post applied for:

Enter the advertised job title.

What is your legal sex?

Female

Male

Prefer not to say

What is your date of birth?

Please enter day, month and year.

Day

Month

Year

Do you have a disability or long-term medical condition?

Please indicate if you have a disability or long-term medical condition (i.e. a physical or mental impairment that has a substantial and long-term adverse effect on your ability to carry out normal day-to-day activities). Please see www.admin.ox.ac.uk/eop/disab for more information.

Yes

No known disability

Prefer not to say

Please provide details, by selecting option(s) from the list below.

(You may select more than one of the options below.)

	Select all that apply
A specific learning difficulty such as dyslexia, dyspraxia or AD(H)D	A specific learning difficulty such as dyslexia, dyspraxia or AD(H)D - Select all that apply
General learning disability (such as Down's Syndrome)	General learning disability (such as Down's Syndrome) - Select all that apply
A social/communication impairment such as Asperger's syndrome/other autistic spectrum disorder	A social/communication impairment such as Asperger's syndrome/other autistic spectrum disorder - Select all that apply
A long-standing illness or health condition such as cancer, HIV, diabetes, epilepsy, chronic fatigue syndrome, etc.	A long-standing illness or health condition such as cancer, HIV, diabetes, epilepsy, chronic fatigue syndrome, etc. - Select all that apply
A mental health condition such as depression, anxiety, bipolar disorder, etc	A mental health condition such as depression, anxiety, bipolar disorder, etc - Select all that apply
A physical impairment or mobility issues	A physical impairment or mobility issues - Select all that apply
Deaf or serious hearing impairment	Deaf or serious hearing impairment - Select all that apply
Blind or serious visual impairment uncorrected by glasses	Blind or serious visual impairment uncorrected by glasses - Select all that apply
Prefer not to say	Prefer not to say - Select all that apply
A disability, impairment or medical condition not included above (please specify in the box below)	A disability, impairment or medical condition not included above (please specify in the box below) - Select all that apply

Name or details of condition if not included above.

What is your nationality? (Including joint/dual nationality.)

Please include any joint nationality.

Please specify, if "other".

Please specify if you selected an "other background" option above.

What is your sexual orientation?

"Sexual orientation" means a person's emotional and sexual attraction towards people of the same sex, opposite sex, both sexes, or neither. It is not related to gender identity.

Please specify if applicable.

Please specify if you selected the "other" option above.

Please specify if applicable.

Provide details of your religion or belief, if not listed above.

Once you have completed your information, please click the Submit button.

You will be directed to a confirmation page, if your submission has been successful.

Thank you for helping us monitor and analyse our equality and diversity demographics of applicants.

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Equality & Diversity Monitoring Form

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