SIGTA Equal Opportunities Monitoring Form SIGTAWe are committed to equality of opportunity and encourage the Companies that we work with to consider applications solely on the basis of ability to perform the job. The data collected here is solely for the purposes of equal opportunities monitoring and will be kept separately from your application form. Please complete the sections below by supplying the information as requested: NameFirstLast Date of Birth01020304050607080910111213141516171819202122232425262728293031day / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecembermonth / 202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901year Gender DisabilityUnder the Disability Discrimination Act 1995 you are considered to be disabled if you have a mental or physical impairment which has a substantial and long term adverse effect upon your ability to carry out normal day to day activities. Do you have a disability that is covered by the Disability Discrimination Act?YesNo Further information: If yes, what is your impairment? Please indicate with a tick any of the following that applBlind / Partially SightedDeaf / Hearing ImpairmentMobility / Wheelchair UseMental Health / Learning DifficultyUnseen Impairment (e.g. Epilepsy, Diabetes, Heart Disease)Other Impairment (please specify) Further Information: Ethnic Background (Please indicate with a tick which of these applies):White: British / Irish (Any other white background, please specify)Mixed: White & Black Caribbean / White & Black African / White & Asian (Any other mixed background, please specify)Asian or Asian British: Indian / Pakistan / Bangladeshi (Any other Asian background, please specify)Black: Caribbean / African / (Any other black background, please specify)Chinese or other ethnic group (please specify) CompletedThank you for completing the form which will be kept separately from your application form. All data collected from this form will be held securely and confidentially.SubmitReset Share this:TwitterFacebookLinkedInPinterestWhatsAppLike this:Like Loading...