REASONS FOR VOLUNTEERING
YOUR SKILLS
YOUR HEALTH
REFERENCES Please give the names and addresses of two people that have known you for over one year and who have given their permission to be approached for a reference. They should not be related to you.
EMERGENCY CONTACT Please give the name of a family member or close friend who we can contact in the event of an emergency.
DISCLOSURES
EQUALITY & DIVERSITY POLICY At Royal Trinity Hospice we are committed to eliminating discrimination and encouraging diversity amongst our workforce. Our aim is that our workforce will be truly representative of all sections of society and that all employees, volunteers, patients and visitors feel respected, and able to give of their best. We aim to create an environment in which individual differences, and the contributions of all our staff, are recognised and valued. To that end the purpose of this policy is to provide equality and fairness for all, and not to discriminate on grounds of gender, gender reassignment, marital status (including civil partnerships), pregnancy or parental status, race, ethnic origin, colour, nationality, national origin, disability, sexual orientation, religion, age. We oppose all forms of unlawful and unfair discrimination. ABOUT THIS FORM In order that we can monitor our success in meeting this commitment, we ask you to complete this equality and diversity monitoring form by providing information on your ethnic origin, whether you are affected by disability and also details of nationality. The information that you provide will be treated as strictly confidential and will not be used to assess your suitability for the post. The data is being requested for monitoring and statistical purposes only and to assist us in meeting statutory and other obligations. Dignity at work We are committed, as an integral part of our equal opportunities policy, to ensuring that male and female applicants are treated fairly and equitably throughout the recruitment process and to respect the dignity of staff and applicants in the working environment. Please tick the appropriate box to indicate your gender. Ethnic origin For the purpose of analysing ethnic origin, Trinity has adopted the categorisation scheme recommended by the Commission for Racial Equality. Please tick the box that you feel most accurately describes your ethnic origin. Disability The Hospice is committed to providing a work environment which is open to all and to respond, as appropriate, to the needs of those with disabilities. Please place a tick in the appropriate box to indicate any disability. Nationality The Hospice seeks data on nationality in order to assist in distinguishing within declared ethnic origins, between UK and overseas staff as well as providing information on recruitment patterns. Sexual Orientation Royal Trinity Hospice is a Stonewall Diversity Champion, and is committed to promoting sexual orientation equality. This section is not obligatory but your information is valuable to us for reporting to our commissioners and other funders. Data Protection In line with the Data Protection Act 1998, Trinity Hospice will use the information given by you for statistical purposes. It may analyse applications by gender, ethnic origin or disability. Your assistance and cooperation in providing the requested data is greatly appreciated and Trinity Hospice thanks you in advance for helping to ensure completeness in our statistical record. You can read our Privacy Notice in full at www.royaltrinityhospice.london/privacy.
You do not have to answer these questions and it will not affect your application. This page will be kept separately from your application form.
Please tick the box that you feel most accurately describes your ethnic origin.
Trinity is committed to providing an environment which is open to all and to respond, as appropriate, to the needs of people with disabilities. Any adaptations or modifications required as a result of a disability will be considered after the interview process.