FAIR EMPLOYMENT MONITORING FORM – PRIVATE & CONFIDENTIAL

DATE:

REF NO:

POSITION APPLIED FOR:

We are an equal opportunity employer. We do not discriminate on grounds of religious belief or political opinion. We practice equality of opportunity in employment and select the best person for the job.

To demonstrate our commitment to equality of opportunity in employment we need to monitor the community background of our applicants and employees, as required by the Fair Employment and Treatment (NI) Order 1998.

EQUALITY OF OPPORTUNITY

Regardless of whether we practice our religion, most of us in Northern Ireland are seen as either Protestant or Roman Catholic. We are therefore asking you to indicate your community background by ticking the appropriate box below.

I am a member of the Protestant community                                                                                        [ ]

I am a member of the Roman Catholic community                                                                               [ ]

I am a member of neither the Protestant nor Roman Catholic community                                      [ ]

Could you please indicate whether you are                                                                Female [ ]                      Male [ ]

If you do not complete this questionnaire, we are encouraged to use the ‘residuary’ method which means that we can make a determination on the basis of personal information on the application form.

Note. It is not compulsory for you to answer the above questions. However we would stress that it is a criminal offence under the legislation for a person to “give false information in connection … with the preparation of a monitoring return