Equal Opportunities Monitoring Form - HSENI - Members

Page 1 of 3

Closes 7 Feb 2025

This service needs cookies enabled.

Equality Monitoring

The Executive Office (TEO) has a responsibility under Section 75 of the Northern Ireland Act 1998, to collect information in order to promote equality of opportunity.

TEO is committed to equality of opportunity and fair treatment in all of its programmes and services. Any information provided by you will only be used by TEO for equality purposes. This information is collected to help improve the programmes and services offered by TEO and to monitor fair participation. All personal data provided will be treated in strict confidence and held in accordance with the provisions of the Data Protection Act.

Please answer the following questions on the Equality Monitoring Form overleaf as fully as possible by ticking the relevant boxes.

You are not obliged to answer the questions on this form, however we would encourage you to do so as all information gathered will only be used for the promotion of equality.

Please provide your National Insurance Number below.
Are you?
What is your date of birth?
Date of Birth

 - 

 - 

Are you married or in a civil partnership?
The Disability Discrimination Act (1995) defines disability as “a physical or mental impairment which has a substantial and adverse effect on a person’s ability to carry out normal day to day activities”. In these terms, do you consider yourself to have a disability?
Which of the following options best describes your sexual orientation?
What is your ethnic group?
What is your community background?
Do you have personal responsibility for the care of a child, or children, a person with a disability or a dependent older person? Please select all that apply.
Which sector would you consider best reflects your employment history over the course of your career?
What is your highest level of educational attainment?