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EQUAL OPPORTUNITIES FORM

This sheet does not form part of the selection process. It will be retained by Human Resources purely for
monitoring purposes. Hill+Knowlton Strategies recognises and actively promotes the benefits of a diverse
workforce and is committed to treating all employees with dignity and respect regardless of race, gender,
disability, age, sexual orientation, religion or belief. We therefore welcome applications from all sections
of the community.

       Name

    Date of Birth

                       即 Male                   即 Female           即 Other (Please specify)
      Gender


   I would describe my ethnic origin as:

Asian or Asian British                Mixed                                  Other Ethnic Group
   即 Bangladeshi                        即 White & Asian                       即 Chinese
   即 Indian                             即 White & Black African               即 Other ethnic group
   即 Pakistani                          即 White & Black Caribbean
   即 Other Asian background             即 Other mixed background

Black or Black British                White
   即 African                            即 British
   即 Caribbean                          即 Irish
   即 Other Black background             即 Other White background


    Please select the option which best describes your sexuality

   即 Lesbian
                                       即 Heterosexual
   即 Gay
                                       即 I do not wish to disclose this
   即 Bisexual

    Please indicate your religion or belief
   即 Atheism                          即 Jainism                          即 Judaism
   即 Buddhism                         即 Sikhism                          即 Hinduism
   即 Christianity                     即 Other (Please specify)           即 I do not wish to disclose this
   即 Islam

Do you consider yourself to have a            即 Yes
disability?                                   即 No
Please state the type of impairment which applies to you. People may experience more than one type of
impairment, in which case you may indicate more than one. If none of the categories apply, please mark
other
   即 Physical Impairment                                即 Learning Disability/Difficulty
   即 Sensory Impairment                                 即 Long-standing illness
   即 Mental Health Condition                            即 Other (please specify)

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Equal opportunities form 2012

  • 1. EQUAL OPPORTUNITIES FORM This sheet does not form part of the selection process. It will be retained by Human Resources purely for monitoring purposes. Hill+Knowlton Strategies recognises and actively promotes the benefits of a diverse workforce and is committed to treating all employees with dignity and respect regardless of race, gender, disability, age, sexual orientation, religion or belief. We therefore welcome applications from all sections of the community. Name Date of Birth 即 Male 即 Female 即 Other (Please specify) Gender I would describe my ethnic origin as: Asian or Asian British Mixed Other Ethnic Group 即 Bangladeshi 即 White & Asian 即 Chinese 即 Indian 即 White & Black African 即 Other ethnic group 即 Pakistani 即 White & Black Caribbean 即 Other Asian background 即 Other mixed background Black or Black British White 即 African 即 British 即 Caribbean 即 Irish 即 Other Black background 即 Other White background Please select the option which best describes your sexuality 即 Lesbian 即 Heterosexual 即 Gay 即 I do not wish to disclose this 即 Bisexual Please indicate your religion or belief 即 Atheism 即 Jainism 即 Judaism 即 Buddhism 即 Sikhism 即 Hinduism 即 Christianity 即 Other (Please specify) 即 I do not wish to disclose this 即 Islam Do you consider yourself to have a 即 Yes disability? 即 No Please state the type of impairment which applies to you. People may experience more than one type of impairment, in which case you may indicate more than one. If none of the categories apply, please mark other 即 Physical Impairment 即 Learning Disability/Difficulty 即 Sensory Impairment 即 Long-standing illness 即 Mental Health Condition 即 Other (please specify)