We believe in valuing diversity. This means that we welcome and encourage applications regardless of age, gender, sexual orientation, race, religion or disability.

To make valuing diversity work we need to monitor the effectiveness of our policies. This is why we ask you to please complete the form below.

The form is not part of our selection process and will be separated from your application form.

If you are successful, the information will be transferred to our computerised personnel system. The information will be kept in strict confidence at all times.

Please fill in the appropriate fields.

First Name(s):
Surname:
Email Address:
Gender:	Female Male
Date of Birth (DD/MM/YY)

Ethnic Group

Which of these groups do you consider that you belong to?

Asian or Asian British	Mixed
Indian	White and Black Caribbean
Pakistani	White and Black African
Bangladeshi	White and Asian background
Any other Asian background	Any other mixed background
Black or Black British	White
Caribbean	British
African	Irish
Any other Black background	Any other White background
Chinese or other ethnic group	If you have answered 'Any other' then please specify below
Chinese
Any other

Disability

Do you consider yourself to have a disability? 'Guidance Notes'	Yes
	No

Employment

Are you currently employed by Devon County Council?	Yes
	No
If you have answered yes to the previous question, are you applying for a higher graded post?	Yes
	No

Where did you first see this post advertised?

Choice Magazine www.devonjobs.gov.uk Other Internet Site Local Newspaper National/Trade Press Other

If other, please specify:

Application Details

Job reference: 142060

• © Devon County Council 2004